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Normal |
Abnormal |
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- The appendix is a collection of
lymphatic tissue (tissue that is part of the body's
immune/defense system). The appendix, connected to the
colon, is a few inches in length and has a lumen (a hollow
portion). Appendicitis is thought to occur when this lumen
becomes obstructed.
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- Pain usually begins near belly
button
- Pain then localizes to the right
lower abdomen
- Nausea/vomiting (occurs after pain
starts and not before)
- Loss of appetite
- Urinary pain/frequency may occur
- Flank, pelvic, or rectal pain may
occur
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- Fecal obstruction
- Parasitic worm obstruction
- Tumor obstruction
- Viral infection of appendix
- Barium obstruction (from a medical
test)
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- Fever
- Fast heart rate
- Rebound tenderness in right lower
abdomen (pain is worse when doctor releases hand from
abdomen)
- Flank, rectal, or pelvic pain if
appendix is in unusual position
- Rigid or diffuse abdominal tenderness if appendix
perforates
- Laboratory tests may be unreliable
in some (e.g., older patients with certain
drugs/medications).
- Elevated white blood cell count
- Urinalysis to check
for other causes
- Abdominal X-Ray (KUB), Ultrasound, or Barium Enemas may
help in certain cases but are not diagnostic.
- Spiral CT scan is now very sensitive in detecting
appendicitis
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- Surgical removal of the appendix
(appendectomy) as soon as possible, unless the doctor feels
a mass on the outside.
- If mass is felt on the outside,
patients are treated with IV antibiotics and fluids, and
appendectomy is done when the patient is more
stable.
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- Seek emergency medical care
Immediately
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- There may be unusual
presentations, such as pain in rectum only and no
abdominal pain, if the appendix is pointed
backwards. Therefore, appendicitis must be
considered as a possible diagnosis in all types of pelvic,
rectal, and back pain, as well as with abdominal pain.
- In infants with fever, Diarrhea, vomiting,
and abdominal pain appendicitis should always be
considered.
- In elderly patients, appendicitis
often presents with less severe pain.
- In pregnant women, appendicitis
occurs in 1 in every 1000 pregnancies, and the enlarged
uterus may push appendix to the right upper abdomen,
causing pain in this
area.
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