What Is the Appendix?
The appendix is a tiny, three- or four-inch tube projecting off your cecum, where the small intestine and the large intestine, also called the colon, join. The appendix is located in the lower right part of your abdomen.
The appendix is a leftover from primitive times—a leftover that has no function in the modern human body. It becomes a medical concern when something clogs it—usually feces, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). A bacterial or viral infection in the digestive tract can cause the lymph nodes in that area to swell and possibly block the appendix. In either case, the appendix may become inflamed—a medical emergency known as appendicitis.
What causes appendicitis?
The causes of appendicitis are not well understood, but it is believed to occur as a result of one or more of these factors: an obstruction within the appendix, the development of an ulceration (an abnormal change in tissue accompanied by the death of cells) within the appendix, and the invasion of bacteria. Under these conditions, bacteria may multiply within the appendix. The appendix may become swollen and filled with pus (a fluid formed in infected tissue, consisting of while blood cells and cellular debris), and may eventually rupture. Signs of rupture include the presence of symptoms for more than 24 hours, a fever, a high white blood cell count, and a fast heart rate. Very rarely, the inflammation and symptoms of appendicitis may disappear but recur again later.
In most cases, a blockage inside the appendix probably starts a process in which the appendix becomes inflamed and infected. If inflammation continues without treatment, the appendix can rupture. A ruptured appendix spills bacteria-laden intestinal contents into the abdominal cavity, causing peritonitis, which may result in a life-threatening infection. A rupture also may cause an abscess (a pus-filled pocket of infection) to form. In a woman, the ovaries and fallopian tubes may become infected, and the resulting blockage of the fallopian tubes may cause infertility. A ruptured appendix also may allow bacteria to infect the bloodstream - a life-threatening condition called sepsis.
How is appendicitis treated?
The only treatment for appendicitis is surgery to remove the appendix (appendectomy). The goal is to remove the appendix before it ruptures and spreads infection to the abdomen (peritonitis).
If your doctor is not sure if you have appendicitis, you may have to wait for several hours at home or in the hospital before a decision about surgery is made. Your doctor may send you home and have you come back in 6 or 8 hours to be rechecked.
Surgery to remove the appendix can be done one of two ways-laparoscopic or traditional. Experts do not agree on which surgery is best. It often depends on what your surgeon prefers. Laparoscopic surgery uses three or four small cuts or incisions and traditional appendectomy uses one larger incision. Most people feel better immediately after surgery. Some people can even go home the same day.
If your appendix has burst and there is infection in your abdomen, you may have to stay in the hospital longer. Your treatment will include intravenous (IV) fluids and antibiotics. Surgery for a burst appendix may be more complicated. If you have a burst appendix, a radiologist may place a drain in your belly to help remove some of the infection before you have surgery to remove it. In this case, the appendix will be taken out a few weeks later. After you have your appendix removed, the doctor may leave the incision (cut) open to heal from the inside to the outside. You may also have a drain placed within the wound to help drain the infection.
You will also have to stay in the hospital longer if you have health problems that get worse after surgery.
Sometimes a doctor will recommend surgery even if he or she is not sure you have appendicitis. Surgery can eliminate the chances of a ruptured appendix. If you have surgery and your appendix is normal, your appendix will still be removed so that it will not cause future problems.