Appendicitis: Know the Signs Before It Bursts!

What Is the Appendix and Why Does It Matter?

The appendix is a small, finger-like pouch attached to the cecum—the first part of the large intestine. Although its exact function remains unclear, inflammation leads to—appendicitis—which is a leading cause of emergency abdominal surgery worldwide, responsible for over 30,000 ER visits each year in the U.S. alone.

What Causes Appendicitis?

Appendicitis usually happens when the opening of the appendix becomes blocked, leading to pressure buildup, bacterial overgrowth, and inflammation. Common causes include:

• Appendicoliths (fecal stones)

• Lymphoid hyperplasia (especially in children)

• Parasites or tumors

Once obstructed, bacteria multiply, causing infection and potentially perforation if not treated quickly. Perforation is a dreaded complication because it can lead to feculent drainage into the abdominal cavity or severe infection.

Symptoms of Appendicitis

Symptoms often develop suddenly and escalate within 24 hours. Classic signs include:

• Pain starting around the belly button, shifting to the right lower abdomen

• Nausea, vomiting, or loss of appetite

• Low-grade fever

• Pain worsened by movement, coughing, or walking

• Diarrhea may occur, especially in children

In some cases—especially in kids or the elderly—symptoms can be vague. A high level of suspicion is essential to avoid delayed treatment, which in turn increases the morbidity of the disease.

How Is Appendicitis Diagnosed?

Diagnosis combines clinical expertise with diagnostic testing:

• Physical Exam: Tenderness in the lower right abdomen

• Lab Tests: Elevated white blood cell count or inflammatory markers

• Imaging:

  • Ultrasound: Useful in children and pregnant patients

  • CT Scan: Most accurate tool for diagnosing appendicitis

Types of Appendicitis:

• Uncomplicated appendicitis: Dilation of the appendix characterized by inflammation. Early stages may be managed with antibiotics.

• Complicated Appendicitis: Severe inflammation is present, often leading to gangrene of the appendix. It often includes an appendicolith, or stool ball, small enough to obstruct the appendix.

• Complicated perforated appendicitis: This is a feared complication of appendicitis. Often caused by delayed hospital presentation. It can lead to feces spreading inside the abdomen and often with severe infection, or abscess, associated with it.

  
  

Treatment Options

Surgical Removal (Appendectomy)

• Laparoscopic or robotic surgery is preferred for quick recovery, less pain and fewer complications. This can also be used for advanced stages or perforation depending on the local expertise.

• Open surgery may be necessary in cases of rupture or severe infection.

Antibiotic Therapy

• Antibiotics are started as soon as appendicitis is suspected.

• In some uncomplicated cases, antibiotics alone may be tried—but 30–50% may recur within 2 years.

Why Early Treatment Matters

Appendicitis can rupture within 24–36 hours of symptom onset, especially if untreated. Complications include:

• Peritonitis: severe inflammation of the intra-abdominal cavity

• Abscess: Contained infection next to the appendix which may require percutaneous drainage prior to surgery

• Sepsis: occurs when infection is severe enough to damage other organ systems

Early diagnosis and surgery dramatically reduce these risks.

Prognosis & Recovery

• Most patients recover within one week after surgery for uncomplicated cases. Typical postoperative restrictions apply for most patients.

• Delayed treatment significantly increases the risk of complications and hospital stay

Frequently Asked Questions

Q: Can appendicitis go away on its own? A: Rarely. Antibiotics may help initially, but surgery is usually required to prevent rupture.

Q: Is appendicitis contagious? A: No. It results from internal blockage, not external infection.

Q: Can kids get appendicitis? A: Yes. It’s the most common cause of emergency abdominal surgery in children.

Q: How soon should it be treated? A: Ideally as soon as possible to prevent serious complications.

Bottom Line

Appendicitis is common, urgent—but highly treatable. Recognizing early symptoms and acting fast can prevent serious complications. If you or a loved one has ongoing abdominal pain—especially in the lower right side—don’t wait. Contact Dr. Hernandez and the Intercoastal Surgery team in Sarasota for expert care when it matters most.