Appendicitis consists of inflammation of the appendix, which is a prolongation of the caecum and located at the beginning of the large intestine in the lower right side of the abdomen.
The most important symptom is abdominal pain, produced by appendicular distension. The pain initially is not very intense and difficult to pinpoint. Later, after several hours, when the peritoneum is already inflamed, the pain is located in the right iliac fossa. It is continuous, becoming more intense and aggravated by movements or by pressure on the abdominal wall. Where the pain is felt will depend on the location of the caecum and the arrangement of the appendix inside it. This means it is sometimes difficult to examine and can be confusing to diagnose.
Abdominal pain is typically accompanied by complete absence of appetite and in 78-80% of cases nausea and vomiting appear in these first few hours, although always after the onset of pain.
The general condition of the patient is usually good, although in advanced stages it may deteriorate. The affected person wants to stay still, avoiding unnecessary movements because of the pain they cause, and after 4-5 hours they develop a mild fever (between 37.5 and 38ºC).
Treatment must be surgical and as urgent as possible. It is better to remove a suspicious appendix, even if it turns out to be normal, than to wait until the situation becomes complicated by peritonitis.
