Acute Appendicitis

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What is acute appendicitis?

Acute appendicitis is a rapidly progressing inflammation of a small part of the large intestine called the appendix. The appendix is a pouch-like structure located in the lower right quadrant of the abdomen near the area where the small intestine joins the large intestine. The exact function of the appendix is not known.

Acute appendicitis is the most common abdominal surgical emergency. It is a common and serious condition that requires immediate surgery for treatment. In acute appendicitis, the appendix swells and begins to fill with rapidly growing bacteria and pus. This results in the hallmark symptoms of acute appendicitis including pain in the right lower area of the abdomen and fever. However, not all people with acute appendicitis will experience typical symptoms.

Acute appendicitis is a medical emergency that generally requires prompt removal of the appendix to prevent life-threatening complications, such as ruptured appendix and peritonitis (infection of the membrane that lines your inner abdomen).

Seek immediate medical care (call 911) if you, or someone you are with, have symptoms of acute appendicitis, such as fever and abdominal pain. Do not consume anything by mouth until your symptoms have been assessed.

What are the symptoms of acute appendicitis?

Classic symptoms of acute appendicitis include pain in the right lower abdomen, where the appendix is located, that gets progressively sharp and more intense. Pain increases when pressure is put on the area (called the McBurney’s point), and the area becomes even more painful and tender when the pressure is released (rebound tenderness). This is one exam a health care provider uses to diagnosis acute appendicitis.

The symptoms of acute appendicitis can vary, and not all people with acute appendicitis will experience the typical symptoms of abdominal pain. In early acute appendicitis, the abdominal pain may be located around the navel or belly button area, then move to McBurney’s point as acute appendicitis progresses.

Symptoms of acute appendicitis can include:

Serious symptoms that might indicate a life-threatening condition

Acute appendicitis can lead to life-threatening complications, such as ruptured appendix, peritonitis and shock. Seek immediate medical care ( call 911) if you, or someone you are with, have any of these symptoms that might indicate a serious or life-threatening condition:

What causes acute appendicitis?

Acute appendicitis can occur when a piece of food, stool or object becomes trapped in the appendix, causing irritation, inflammation, and the rapid growth of bacteria and leading to infection. The appendix is a pouch-like structure located in the lower right quadrant of the abdomen near the area where the small intestine joins the large intestine.

Acute appendicitis can also happen after a gastrointestinal infection. Rarely, a tumor may cause acute appendicitis. Sometimes the cause of acute appendicitis is not known.

What are the risk factors for acute appendicitis?

Acute appendicitis can occur in any age group or population. However, it most often occurs in teens and young adults. It is rare in children younger than two years of age.  

Risk factors for acute appendicitis include:

  • Being a child older than age two, a teen, or a young adult

  • Cystic fibrosis

  • Family history of acute appendicitis

How is acute appendicitis treated?

Acute appendicitis is a treatable condition. If acute appendicitis is diagnosed and treated promptly before the appendix ruptures, the outcome is generally very good. Treatment for appendicitis includes hospitalization and:

  • Intravenous antibiotics to clear any infections

  • Laparoscopic appendectomy, a minimally invasive surgery to remove the appendix, requiring small incisions

  • Open appendectomy, a more invasive surgical procedure to remove the appendix and clean out the abdominal cavity. This procedure is performed if the appendix ruptures before it is surgically removed.

  • Pain medications

People in good health generally recover from an appendectomy procedure quickly without complications, particularly if the procedure is performed before the appendix ruptures. Hospitalization may be as short as a couple of days.

What are the possible complications of acute appendicitis?

Acute appendicitis that is not treated promptly leads to life-threatening complications. Complications of acute appendicitis include:

  • Abdominal abscess

  • Peritonitis  (infection of the lining that surrounds the abdomen)

  • Ruptured appendix

  • Sepsis

  • Shock

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. Appendicitis. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000256.htm.
  2. Appendicitis. National Digestive Diseases Information Clearinghouse (NDDIC). http://digestive.niddk.nih.gov/ddiseases/pubs/appendicitis/.
  3. Kahan S, Miller R, Smith EG (Eds.). In A Page Signs & Symptoms, 2d ed. Philadelphia: Lippincott, Williams & Williams, 2009.
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