Member Information
Get Connected
Search by Category
 Medical Alert Devices

Home Search by Zip US Directory Contact Members Login Register Open Jobs

Post articles View all articles Print article


Appendicitis, or epityphlitis, is a condition characterized by inflammation of the appendix. While mild cases may resolve without treatment, most require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly due to peritonitis and shock.

Appendicitis, or epityphlitis, is a condition characterized by inflammation of the appendix. While mild cases may resolve without treatment, most require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly due to peritonitis and shock.



The causes of appendicitis are generally unknown, but the leading theory is that obstruction of the appendiceal orifice is the inciting factor. Obstruction may come from fecal matter lodged in the appendix, impaction of mucous, a small tumor (such as a carcinoid), or even a small blood clot. Viral infections, which can cause ulceration of the lining, can also lead to obstruction of the appendix through proliferation of lymphatic tissue in its walls. A viral etiology is a possible explanation for seasonal variations in rates of appendicitis and clustering of cases. Regardless of the cause, obstruction of the appendix may lead to progressive appendiceal distension. This distension increases the pressure within the appendix, which in turn impairs its blood supply. Deprived of blood, the appendix loses the ability to fight infection and fecal bacteria begin to grow out of control. Although spontaneous recovery can rarely occur, with time and lack of treatment the walls of the appendix eventually become gangrenous from the infection and lack of blood flow. As bacteria begin to leak out through the dying walls, pus forms within and around the appendix (suppuration). The end result of this cascade is appendiceal rupture causing peritonitis, which may lead to septicemia and eventually death.


Although the model described above is traditionally taught in medical schools, histories of patients operated for appendicitis do not often correlate well with such a single disease progression. Specifically, those with atypical histories have findings at surgery that are consistent with a suppurative process that starts at the onset of symptoms and then smolders. Patients with typical histories may have findings suggesting resolution. Histories to suggest rupture of the appendix while patients are being diagnostically observed are exceedingly rare.


Thus appendicitis is now considered by some to behave as two distinct disease processes, typical and atypical (or suppurative). Approximately 2/3 of patients with appendicitis have typical histories, and findings suggest a virus or mild obstruction as a cause. In the 1/3 with atypical histories, an early suppurative process begins at the clinical onset, and severe unremitting obstruction is the likely cause. In any case, early operation is the best treatment for either type of appendicitis.


Signs, Symptoms and Findings

Appendicitis can be classified into two types, typical and atypical. The pain of typical acute appendicitis usually starts centrally (periumbilical) before localizing to the right iliac fossa (the lower right side of the abdomen). There is usually associated loss of appetite (anorexia) and fever. Nausea, or vomiting may or may not occur. These classic signs and symptoms are more likely the younger the patient. Older patients (beyond their teenage years) may present with only one or two. Diagnosis is easier in typical acute appendicitis and surgery removes a swollen appendix with little or no suppuration (pus) if operated early (within 24 hours of onset).


Atypical histories are not unusual and are more often associated with suppurative appendicitis. This condition often starts with right lower quadrant pain and may smolder for several days before a diagnosis of appendicitis can be made. Diagnosis is more difficult and surgery removes an appendix that is suppurative, gangrenous or ruptured.


There is typically pain and tenderness in the right iliac fossa in both typical and atypical (suppurative) appendicitis. Rebound tenderness may be present suggesting that there is some element of peritoneal irritation. If the abdomen is involuntarily guarded, there should be a strong suspicion of peritonitis requiring urgent surgical intervention.




Diagnosis is based on history and physical examination backed by an elevation of neutrophilic white cells on blood testing and imaging.

The classical history in appendicitis is diffuse pain in the periumbilical region which then localizes as pain and tenderness at McBurney's point (associated with an inflamed appendix coming in contact with the surrounding parietal peritoneum. This point is located on the right-hand side of the abdomen one-third of the distance between the anterior superior iliac spine and the navel. Here, on gentle palpation, the abdominal muscles often feel firm to rigid because of involuntary spasm, and a cough too produces a localized soreness.


Other physical findings include right-side tenderness on a digital rectal exam. Since the appendix normally lies on the right, if a finger is inserted into the rectum and there is tenderness when pressure is applied toward the right, this indicates an increased likelihood that the patient has appendicitis.


Other signs used in the diagnosis of appendicitis are the psoas sign (useful in retrocecal appendicitis), the obturator sign (specifically the obturator internus muscle), Blumberg's sign, and Rovsing's sign.


Ultrasonography and Doppler sonography also provide useful means to detect appendicitis, especially in children. In some cases (15% approximately), however, ultrasonography of the iliac fossa does not reveal any abnormalities despite the presence of appendicitis. This is especially true of early appendicitis before the appendix has become significantly distended and in adults where larger amounts of fat and bowel gas make actually seeing the appendix technically difficult. Despite these limitations, in experienced hands sonographic imaging can often distinguish between appendicitis and other diseases with very similar symptoms such as inflammation of lymph nodes near the appendix or pain originating from other pelvic organs such as the ovaries or fallopian tubes.


In places where it is readily available, CT scan has become the diagnostic test of choice, especially in adults. A properly performed CT scan with modern equipment has a detection rate (sensitivity) of over 95% and a similar specificity. Signs of appendicitis on CT scan include lack of contrast (oral dye) in the appendix and direct visualization of appendiceal enlargement (greater than 6 mm in diameter on cross section). The inflammation caused by appendicitis in the surrounding peritoneal fat (so called "fat stranding") can also be observed on CT, providing a mechanism to detect early appendicitis and a clue that appendicitis may be present even when the appendix is not well seen. Thus, diagnosis of appendicitis by CT is made more difficult in very thin patients and in children, both of whom tend to lack significant fat within the abdomen. In most cases, however, appendicitis is a clinical diagnosis and, due to the high radiation dose involved, CT scans are only used when the diagnosis is in doubt or if there are other considerations involved.



Appendicitis can be treated by removal of the appendix through a surgical procedure called an appendicectomy (also known as an appendectomy). Traditionally, appendectomy has involved an open laparotomy incision.

Often now the operation can be performed via a laparoscopic approach, or via small incisions with a camera to visualize the area of interest in the abdomen. If the findings reveal suppurative appendicitis with complications such as rupture, abscess, adhesions, etc., conversion to open laparotomy may be necessary.


Antibiotics are often given intravenously to help kill remaining bacteria and thus reduce the incidence of infectious complication in the abdomen or wound.




Most appendicitis patients recover easily with treatment, but complications can occur if treatment is delayed or if peritonitis occurs.


Recovery time depends on age, condition, complications, and other circumstances but usually is between 10 and 28 days.


The real possibility of life-threatening peritonitis is the reason why acute appendicitis warrants speedy evaluation and treatment. The patient may have to undergo a medical evacuation. Appendectomies have occasionally been performed in emergency conditions (i.e. outside of a proper hospital), when a timely medical evacuation was impossible.


Typical acute appendicitis responds quickly to appendectomy and occasionally will resolve spontaneously. Atypical appendicitis (associated with suppurative appendicitis) is more difficult to diagnose and is more apt to be complicated even when operated early. In either condition prompt diagnosis and appendectomy yield the best results with full recovery in two to four weeks usually. Mortality and severe complications are unusual but do occur, especially if peritonitis persists untreated.


All text of this article available under the terms of the GNU Free Documentation License (see Copyrights for details).

Medical Alert System Providers   Show All articles
Search by Zip
  Enter Zip  search
Contact Medical Alert System Providers near you.
Firstname *
Lastname *
Email *
Phone *
Alt. Phone
Zip *
Brief reason to contact *
Los Angeles Medical Alert System ProviderMIAMI-DADE Medical Alert System ProviderCook Medical Alert System Provider
SAINT LOUIS Medical Alert System ProviderHarris Medical Alert System ProviderMaricopa Medical Alert System Provider
Orange Medical Alert System ProviderSan Diego Medical Alert System ProviderPRINCE GEORGES Medical Alert System Provider
Kings Medical Alert System ProviderDade Medical Alert System ProviderQueens Medical Alert System Provider
Dallas Medical Alert System ProviderWayne Medical Alert System ProviderKing Medical Alert System Provider
San Bernardino Medical Alert System ProviderSanta Clara Medical Alert System ProviderDEKALB Medical Alert System Provider
Broward Medical Alert System ProviderDU PAGE Medical Alert System ProviderRiverside Medical Alert System Provider
New York Medical Alert System ProviderPhiladelphia Medical Alert System ProviderMiddlesex Medical Alert System Provider
Tarrant Medical Alert System ProviderAlameda Medical Alert System ProviderSuffolk Medical Alert System Provider
Cuyahoga Medical Alert System ProviderBexar Medical Alert System ProviderClark Medical Alert System Provider
More information...
A Guide To Medical Alerts
Medical alerts are devices that help the patient, to get adequate help of the right type during an emergency. They have become an acceptable and obligatory fashion accessory in the present day world....
Home Medical Alert Systems
Home medical alert systems are medical alert systems designed to help individuals and senior citizens who are often at home alone....
Buying Medical Alert Systems
It is advisable to buy a medical alert system before disaster strikes. Many people wait for an emergency to arise before buying a medical alert device....
Discount Medical Alert Systems
Medical alert systems are necessary in case of elderly people staying alone or in case of patients with problems such as heart disease, Alzheimers or asthma....
Medical Alert Bracelets for Diabetics
If you or someone you love has diabetes, getting a diabetic medical alert bracelet is imperative. Because of the nature of the condition, diabetics can have medical emergencies at any time....
Auto Medical Alert Systems
Auto medical alert systems are emergency response systems designed to overcome any life threatening situation. It is a small and non-intrusive device providing independence, security and fast response...
Electronic Medical Alert Systems
Electronic medical alert system is an emergency monitoring system for seniors and frail persons. It serves as an invaluable security and safety device for seniors living alone...
Emergency Medical Alert Systems
Emergency medical alert systems are designed to provide medical help in emergency situations. These are medical alert systems extremely helpful in situations that arise from injuries or illnesses...
Medical Alert Bracelets
Fashionable medical identification jewelry is a perfect solution for those who suffer from critical medical conditions like epilepsy, stroke, diabetes, heart transplant, fainting fits, asthma, memory ...
Medical Alert Services
Certain companies provide Medical Alert Services not only to senior citizens, but also to persons of all ages who suffer from critical medical conditions which may deteriorate suddenly and necessitate...
Medical Alert Wristwatches
Medical alerts are devices that have been responsible for saving quite a few lives. They are available in various types. Some of them are in the form of wristwatches that can be worn by the patient....
Medical Alert Cards
Almost everyone suffers from one form of malady or another. Besides, the strain of cutthroat work environments may make you vulnerable to nervous and even physical breakdowns....
Medical Alert ID
The information on the medical IDs saves the precious time taken for diagnosis and ensures timely treatment. Medical alert identifications are a sure shot way to get immediate treatment in emergency....
Medical Alert Alarm
Medical alert alarms are alarm systems that are used to summon immediate medical attention in emergency situations. ...
Medical Alert Tags
Medical alert tags are medical identification tags that contain important medical information of the person wearing it. ...
Medical Alert Jewelry
The medical information of the person such as drug allergies, food allergies, their prescribed medicines and even emergency phone numbers can be engraved on a medical alert jewelry...
How to choose a medical alert system?
A consumer best chooses a medical alert system depending on his particular situation, budget and needs. Choosing a medical Alert system for an emergency is not an easy task. ...
What are Medical Alert Systems?
They prove helpful during an in home emergency. These are electronic wireless devices worn on your body to alert friends, family and doctors in case of any medical emergency....
Medical Alert Products
Patients suffering from serious health conditions such as cardiac problems, severe allergies, diabetes, epilepsy and other chronic illness are in need of medical alert products. ...
Medical Alert Systems
Most of the alert systems are connected through your phone line and are similar to an answering machine. A typical medical alert system is a console that is equipped with a very loud speaker ...

Contact Us | Site Map | RSS Feeds | Articles | Jobs | All Members | Popular Searches | Popular Questions