Acute Appendicitis

Acute appendicitis is inflammation of the appendix, a small pouch attached to the large intestine. It is one of the most common causes of acute abdominal pain requiring emergency surgery, and delayed treatment increases the risk of the appendix rupturing.

• Abdominal pain that often starts around the navel and moves to the lower right side of the abdomen over several hours
• Loss of appetite
• Nausea and vomiting
• Low-grade fever
• Pain that worsens with movement, coughing, or pressing on and releasing the lower right abdomen
• Signs of rupture (a surgical emergency) include worsening, more widespread abdominal pain, a rigid abdomen, and higher fever

• Usually caused by blockage of the appendix, often by hardened stool, leading to inflammation and infection of the trapped contents.
• Can occur at any age but is most common in children and young adults.

• Diagnosed primarily through clinical history and examination, looking for the characteristic pattern of pain migration and tenderness over the lower right abdomen, sometimes supported by specific examination findings.
• Blood tests may show signs of infection or inflammation.
• Abdominal ultrasound, where available, can support the diagnosis, particularly in children, women, and uncertain cases.

Suspected appendicitis is a surgical emergency requiring urgent referral to a facility with surgical capability.

Surgical removal of the appendix (appendicectomy) is the definitive treatment and is usually performed as soon as the diagnosis is confirmed or strongly suspected.

Intravenous fluids and antibiotics are given before and after surgery to treat infection and support recovery, particularly if there is any suspicion of rupture or abscess formation.

If the appendix has already ruptured, more extensive surgery and a longer course of antibiotics may be needed, along with management of any resulting abscess or infection in the abdominal cavity.

Pain relief is given while arranging urgent transfer, but strong pain medicine should not be given in a way that delays urgent surgical assessment or masks worsening signs.

• Seek prompt medical assessment for abdominal pain that is worsening or moving to the lower right side, rather than waiting to see if it resolves.
• Avoid taking laxatives or strong pain medicine for undiagnosed abdominal pain, as this can mask worsening symptoms or complicate diagnosis.
• Seek urgent care immediately if abdominal pain becomes severe, widespread, or is associated with a rigid abdomen and high fever.