yes it could be ur appendex....but i was in a severe car accident last fall....my
lower abodmen hurted for several of months afterwards due to i was severe bruised inside and outside. after the swellen went down in my organs....my abodomen was still bruised and
sore for a while. Wll yes it may take up to a few more
weeks or longer before those
abdomen muscles to heal up. You need to stregethnth them. also take ibrobrofen for the anitinflamitory and for the
pain. it help with...but check with ur doctor 1st please. I would get ur appendex and also ur gall
bladder checked out any ways.
Appendicitis and
Appendectomy Medical Author: Dennis Lee, M.D. Medical Editor and Revising Author: Jay W. Marks, M.D. * What is the
appendix? * What is
appendicitis? * What are the complications of
appendicitis? * What are the symptoms of
appendicitis? * How is
appendicitis diagnosed? * Why can it be difficult to diagnose
appendicitis? * What other conditions mimic
appendicitis? * How is
appendicitis treated? * How is an
appendectomy done? * What are the complications of
appendectomy? * Are there long-term consequences of removing the
appendix? * What is new about
appendicitis? *
Appendectomy At A Glance * Related
Appendicitis articles:
Appendicitis - on WebMD
Appendicitis - on eMedicine Health What is the
appendix? The
appendix is a closed-ended, narrow
tube up to several inches in length that attaches to the cecum (the first part of the
colon) like a worm. (The anatomical name for the
appendix, vermiform
appendix, means worm-like appendage.) The inner lining of the
appendix produces a small amount of mucus that flows through the open center of the
appendix and into the cecum. The wall of the
appendix contains lymphatic tissue that is part of the immune system for making antibodies. Like the rest of the
colon, the wall of the
appendix also contains a layer of muscle, but the muscle is poorly developed.
Appendicitis Illustration -Inflammation of the
Appendix What is
appendicitis?
Appendicitis means inflammation of the
appendix. It is thought that
appendicitis begins when the opening from the
appendix into the cecum becomes blocked. The
blockage may be due to a build-up of thick mucus within the
appendix or to stool that enters the
appendix from the cecum. The mucus or stool hardens, becomes rock-like, and blocks the opening. This rock is called a fecalith (literally, a rock of stool). At other times, the lymphatic tissue in the
appendix may swell and block the
appendix. After the
blockage occurs, bacteria which normally are found within the
appendix begin to invade (infect) the wall of the
appendix. The body responds to the invasion by mounting an attack on the bacteria, an attack called inflammation. An alternative theory for the cause of
appendicitis is an initial rupture of the
appendix followed by spread of bacteria outside the
appendix.. The cause of such a rupture is unclear, but it may relate to changes that occur in the lymphatic tissue, for example, inflammation, that line the wall of the
appendix.) If the inflammation and
infection spread through the wall of the
appendix, the
appendix can rupture. After rupture,
infection can spread throughout the
abdomen; however, it usually is confined to a small area surrounding the
appendix (forming a peri-appendiceal abscess). Sometimes, the body is successful in containing ("healing") the
appendicitis without surgical
treatment if the
infection and accompanying inflammation do not spread throughout the
abdomen. The inflammation,
pain and symptoms may
disappear. This is particularly true in elderly patients and when
antibiotics are used. The patients then may come to the doctor long after the
episode of
appendicitis with a lump or a mass in the right
lower abdomen that is due to the scarring that occurs during
healing. This lump might raise the suspicion of cancer. What are the complications of
appendicitis? The most frequent complication of
appendicitis is perforation. Perforation of the
appendix can lead to a periappendiceal abscess (a collection of infected pus) or diffuse peritonitis (infection of the entire lining of the
abdomen and the
pelvis). The
major reason for appendiceal perforation is delay in diagnosis and
treatment. In general, the longer the delay between diagnosis and
surgery, the more likely is perforation. The risk of perforation 36 hours after the onset of symptoms is at least 15%. Therefore, once
appendicitis is diagnosed,
surgery should be done without unnecessary delay. A less common complication of
appendicitis is
blockage of the
intestine.
Blockage occurs when the inflammation surrounding the
appendix causes the intestinal muscle to stop working, and this prevents the intestinal contents from passing. If the
intestine above the
blockage begins to
fill with liquid and
gas, the
abdomen distends and
nausea and vomiting may occur. It then may be necessary to drain the contents of the
intestine through a
tube passed through the nose and esophagus and into the
stomach and
intestine. A feared complication of
appendicitis is sepsis, a condition in which infecting bacteria enter the
blood and travel to other parts of the body. This is a very serious, even life-threatening complication. Fortunately, it occurs infrequently
Appendicitis (cont.) In this Article * What is the
appendix? * What is
appendicitis? * What are the complications of
appendicitis? * What are the symptoms of
appendicitis? * How is
appendicitis diagnosed? * Why can it be difficult to diagnose
appendicitis? * What other conditions mimic
appendicitis? * How is
appendicitis treated? * How is an
appendectomy done? * What are the complications of
appendectomy? * Are there long-term consequences of removing the
appendix? * What is new about
appendicitis? *
Appendectomy At A Glance *
Appendicitis Glossary *
Appendicitis Index What are the symptoms of
appendicitis? The main
symptom of
appendicitis is abdominal
pain. The
pain is at first diffuse and poorly localized, that is, not confined to one
spot. (Poorly localized
pain is typical whenever a problem is confined to the small
intestine or
colon, including the
appendix.) The
pain is so difficult to pinpoint that when asked to point to the area of the
pain, most people indicate the location of the
pain with a circular motion of their hand around the central part of their
abdomen. A second, common, early
symptom of
appendicitis is loss of appetite which may progress to
nausea and even vomiting.
Nausea and vomiting also may occur later due to intestinal obstruction. As appendiceal inflammation increases, it extends through the
appendix to its outer covering and then to the lining of the
abdomen, a thin membrane called the peritoneum. Once the peritoneum becomes inflamed, the
pain changes and then can be localized clearly to one small area. Generally, this area is between the front of the right hip bone and the
belly button. The exact point is named after Dr. Charles McBurney--McBurney`s point. If the
appendix ruptures and
infection spreads throughout the
abdomen, the
pain becomes diffuse again as the entire lining of the
abdomen becomes inflamed. How is
appendicitis diagnosed? The diagnosis of
appendicitis begins with a thorough history and physical examination. Patients often have an elevated temperature, and there usually will be moderate to severe tenderness in the right
lower abdomen when the doctor
pushes there. If inflammation has spread to the peritoneum, there is
frequently rebound tenderness. Rebound tenderness is
pain that is worse when the doctor quickly releases his hand after gently
pressing on the
abdomen over the area of tenderness. White
Blood Cell Count The white
blood cell count in the
blood usually becomes elevated with
infection. In early
appendicitis, before
infection sets in, it can be
normal, but most often there is at least a
mild elevation even early. Unfortunately,
appendicitis is not the only condition that causes elevated white
blood cell counts. Almost any
infection or inflammation can cause this count to be abnormally high. Therefore, an elevated white
blood cell count alone cannot be used as a sign of
appendicitis. Urinalysis Urinalysis is a microscopic examination of the
urine that detects red
blood cells, white
blood cells and bacteria in the
urine. Urinalysis usually is abnormal when there is inflammation or stones in the
kidneys or
bladder. The urinalysis also may be abnormal with
appendicitis because the
appendix lies near the ureter and
bladder. If the inflammation of
appendicitis is great enough, it can spread to the ureter and
bladder leading to an abnormal urinalysis. Most patients with
appendicitis, however, have a
normal urinalysis. Therefore, a
normal urinalysis suggests
appendicitis more than a urinary tract problem. Abdominal X-Ray An abdominal x-ray may detect the fecalith (the hardened and calcified, pea-sized piece of stool that blocks the appendiceal opening) that may be the cause of
appendicitis. This is especially true in children. Ultrasound An ultrasound is a painless procedure that uses sound waves to identify organs within the body. Ultrasound can identify an enlarged
appendix or an abscess. Nevertheless, during
appendicitis, the
appendix can be seen in only 50% of patients. Therefore, not seeing the
appendix during an ultrasound does not exclude
appendicitis. Ultrasound also is helpful in
women because it can exclude the presence of conditions involving the ovaries,
fallopian tubes and uterus that can mimic
appendicitis. Barium Enema A barium enema is an x-ray test where liquid barium is inserted into the
colon from the anus to
fill the
colon. This test can, at times, show an impression on the
colon in the area of the
appendix where the inflammation from the adjacent inflammation impinges on the
colon. Barium enema also can exclude other intestinal problems that mimic
appendicitis, for example Crohn`s
disease. Computerized tomography (CT) Scan In patients who are not
pregnant, a CT Scan of the area of the
appendix is useful in diagnosing
appendicitis and peri-appendiceal abscesses as well as in excluding other diseases inside the
abdomen and
pelvis that can mimic
appendicitis.
Laparoscopy Laparoscopy is a surgical procedure in which a small fiberoptic
tube with a camera is inserted into the
abdomen through a small
puncture made on the abdominal wall.
Laparoscopy allows a direct view of the
appendix as well as other abdominal and
pelvic organs. If
appendicitis is found, the inflamed
appendix can be
removed with the laparascope. The disadvantage of
laparoscopy compared to ultrasound and CT is that it requires a general anesthetic. There is no one test that will diagnose
appendicitis with certainty. Therefore, the approach to suspected
appendicitis may include a
period of observation, tests as previously discussed, or
surgery.
Appendicitis In this Article * What is the
appendix? * What is
appendicitis? * What are the complications of
appendicitis? * What are the symptoms of
appendicitis? * How is
appendicitis diagnosed? * Why can it be difficult to diagnose
appendicitis? * What other conditions mimic
appendicitis? * How is
appendicitis treated? * How is an
appendectomy done? * What are the complications of
appendectomy? * Are there long-term consequences of removing the
appendix? * What is new about
appendicitis? *
Appendectomy At A Glance *
Appendicitis Glossary *
Appendicitis Index Why can it be difficult to diagnose
appendicitis? It can be difficult to diagnose
appendicitis. The position of the
appendix in the
abdomen may vary. Most of the
time the
appendix is in the right
lower abdomen, but the
appendix, like other parts of the
intestine, has a mesentery. This mesentery is a sheet-like membrane that attaches the
appendix to other structures within the
abdomen. If the mesentery is large, it allows the
appendix to move around. In addition, the
appendix may be longer than
normal. The combination of a large mesentery and a long
appendix allows the
appendix to dip down into the
pelvis (among the
pelvic organs in
women). It also may allow the
appendix to move behind the
colon (called a retro-colic
appendix). In either case, inflammation of the
appendix may act more like the inflammation of other organs, for example, a woman`s
pelvic organs. The diagnosis of
appendicitis also can be difficult because other
inflammatory problems may mimic
appendicitis. Therefore, it is common to observe patients with suspected
appendicitis for a
period of
time to see if the problem will resolve on its own or develop characteristics that more strongly suggest
appendicitis or, perhaps, another condition. What other conditions can mimic
appendicitis? The surgeon faced with a patient suspected of having
appendicitis always must consider and look for other conditions that can mimic
appendicitis. Among the conditions that mimic
appendicitis are: * Meckel`s
diverticulitis. A Meckel`s diverticulum is a small outpouching of the small
intestine which usually is located in the right
lower abdomen near the
appendix. The diverticulum may become inflamed or even perforate (break open or rupture). If inflamed and/or perforated, it usually is
removed surgically. *
Pelvic inflammatory disease. The right
fallopian tube and ovary
lie near the
appendix. Sexually active
women may contract infectious diseases that involve the
tube and ovary. Usually,
antibiotic therapy is sufficient
treatment, and surgical removal of the
tube and ovary are not necessary. *
Inflammatory diseases of the right
upper abdomen. Fluids from the right
upper abdomen may drain into the
lower abdomen where they stimulate inflammation and mimic
appendicitis. Such fluids may come from a perforated duodenal ulcer,
gallbladder disease, or
inflammatory diseases of the liver, e.g., a liver abscess. * Right-sided
diverticulitis. Although most diverticuli are located on the
left side of the
colon, they occasionally occur on the right
side. When a right-sided diverticulum ruptures it can provoke inflammation they mimics
appendicitis. *
Kidney diseases. The right
kidney is close enough to the
appendix that
inflammatory problems in the kidney-for example, an abscess-can mimic
appendicitis. Next: How is
appendicitis treated?
Appendicitis (cont.) In this Article * What is the
appendix? * What is
appendicitis? * What are the complications of
appendicitis? * What are the symptoms of
appendicitis? * How is
appendicitis diagnosed? * Why can it be difficult to diagnose
appendicitis? * What other conditions mimic
appendicitis? * How is
appendicitis treated? * How is an
appendectomy done? * What are the complications of
appendectomy? * Are there long-term consequences of removing the
appendix? * What is new about
appendicitis? *
Appendectomy At A Glance *
Appendicitis Glossary *
Appendicitis Index How is
appendicitis treated? Once a diagnosis of
appendicitis is made, an
appendectomy usually is performed.
Antibiotics almost always are begun prior to
surgery and as soon as
appendicitis is suspected. There is a small group of patients in whom the inflammation and
infection of
appendicitis remain
mild and localized to a small area. The body is able not only to contain the inflammation and
infection but to resolve it as well. These patients usually are not very ill and improve during several days of observation. This type of
appendicitis is referred to as "confined appendicitis" and may be treated with
antibiotics alone. The
appendix may or may not be
removed at a later
time. On occasion, a person may not see their doctor until
appendicitis with rupture has been present for many days or even
weeks. In this situation, an abscess usually has formed, and the appendiceal perforation may have closed over. If the abscess is small, it initially can be treated with
antibiotics; however, the abscess usually requires drainage. A drain (a small plastic or rubber
tube) usually is inserted through the skin and into the abscess with the aid of an ultrasound or CT scan that can determine the exact location of the abscess. The drain allows pus to flow from the abscess out of the body. The
appendix may be
removed several
weeks or months after the abscess has resolved. This is called an interval
appendectomy and is done to prevent a second attack of
appendicitis. How is an
appendectomy done? During an
appendectomy, an incision two to three inches in length is made through the skin and the layers of the abdominal wall over the area of the
appendix. The surgeon enters the
abdomen and looks for the
appendix which usually is in the right
lower abdomen. After examining the area around the
appendix to be certain that no additional problem is present, the
appendix is
removed. This is done by freeing the
appendix from its mesenteric attachment to the
abdomen and
colon, cutting the
appendix from the
colon, and sewing over the hole in the
colon. If an abscess is present, the pus can be drained with drains that pass from the abscess and out through the skin. The abdominal incision then is closed. Newer techniques for removing the
appendix involve the use of the laparoscope. The laparoscope is a thin telescope attached to a
video camera that allows the surgeon to inspect the inside of the
abdomen through a small
puncture wound (instead of a larger incision). If
appendicitis is found, the
appendix can be
removed with special instruments that can be passed into the
abdomen, just like the laparoscope, through small
puncture wounds. The benefits of the
laparoscopic technique include less post-operative
pain (since much of the post-surgery
pain comes from incisions) and a speedier return to
normal activities. An additional advantage of
laparoscopy is that it allows the surgeon to look inside the
abdomen to make a clear diagnosis in cases in which the diagnosis of
appendicitis is in doubt. For example,
laparoscopy is especially helpful in menstruating
women in whom a rupture of an ovarian cysts may mimic
appendicitis. If the
appendix is not ruptured (perforated) at the
time of
surgery, the patient generally is sent home from the hospital after
surgery in one or two days. Patients whose
appendix has perforated are sicker than patients without perforation, and their hospital stay often is prolonged (four to seven days), particularly if peritonitis has occurred. Intravenous
antibiotics are given in the hospital to fight
infection and assist in resolving any abscess. Occasionally, the surgeon may find a normal-appearing
appendix and no other cause for the patient`s problem. In this situation, the surgeon may remove the
appendix. The reasoning in these cases is that it is better to remove a normal-appearing
appendix than to miss and not treat appropriately an early or
mild case of
appendicitis. What are the complications of
appendectomy? The most common complication of
appendectomy is
infection of the
wound, that is, of the surgical incision. Such infections vary in severity from
mild, with only redness and perhaps some tenderness over the incision, to moderate, requiring only
antibiotics, to severe, requiring
antibiotics and surgical
treatment. Occasionally, the inflammation and
infection of
appendicitis are so severe that the surgeon will not close the incision at the end of the
surgery because of concern that the
wound is already infected. Instead, the surgical closing is postponed for several days to allow the
infection to subside with
antibiotic therapy and make it less likely for
infection to occur within the incision.
Wound infections are less common with
laparoscopic surgery. Another complication of
appendectomy is an abscess, a collection of pus in the area of the
appendix. Although abscesses can be drained of their pus
surgically, there are also non-surgical techniques, as previously discussed. Are there long-term consequences of
appendectomy? It is not clear if the
appendix has an important role in the body in older children and adults. There are no
major, long-term health problems resulting from removing the
appendix although a slight
increase in some diseases has been noted, for example, Crohn`s
disease. What is new about
appendicitis? Recently it has been hypothesized that some episodes of appendicitis-like symptoms, especially recurrent symptoms, may be due to an increased sensitivity of the
intestine and
appendix from a prior
episode of inflammation. That is, the recurrent symptoms are not due to recurrent episodes of inflammation. Rather, prior inflammation has made the nerves of the intestines and
appendix or the central nervous system that innervate them more sensitive to
normal stimuli, that is, with stimuli other than inflammation. This will be a difficult, if not impossible, hypothesis to confirm.
Appendectomy At A Glance * The
appendix is a small, worm-like appendage attached to the
colon. *
Appendicitis occurs when bacteria invade and infect the wall of the
appendix. * The most common complications of
appendicitis are abscess and peritonitis. * The most common manifestations of
appendicitis are
pain, fever, and abdominal tenderness. *
Appendicitis usually is suspected on the basis of a patient`s history and physical examination; however, a white
blood cell count, urinalysis, abdominal x-ray, barium enema, ultrasonography, CT, and
laparoscopy also may be helpful in diagnosis. * Due to the varying size and location of the
appendix and the proximity of other organs to the
appendix, it may be difficult to differentiate
appendicitis from other abdominal and
pelvic diseases.
* The treatment for appendicitis usually is antibiotics and appendectomy (surgery to remove the appendix). * Complications of
appendectomy include
wound infection and abscess
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