Anatomy: The appendix sits at the junction of the small intestine and large intestine. It’s a thin tube about four inches long. Normally, the appendix sits in the lower right abdomen.
The function of the appendix is unknown. One theory is that the appendix acts as a storehouse for good bacteria, “rebooting” the digestive system after diarrheal illnesses. Other experts believe the appendix is just a useless remnant from our evolutionary past. Surgical removal of the appendix causes no observable health problems.
Appendicitis: For unclear reasons, the appendix often becomes inflamed, infected, and can rupture. This causes severe pain in the right lower part of the belly, along with nausea and vomiting.
Tumors of the appendix: Carcinoid tumors secrete chemicals that cause periodic flushing, wheezing, and diarrhea. Epithelial tumors are growths in the appendix that can be benign or cancerous. Appendix tumors are rare.
SIGNS AND SYMPTOMS OF APPENDICITIS:
Deep tenderness at McBurney’s point, known as McBurney’s sign, is a sign of acute appendicitis. The clinical sign of referred pain in the epigastrium when pressure is applied is also known as Aaron’s sign. Specific localization of tenderness to McBurney’s point indicates that inflammation is no longer limited to the lumen of the bowel (which localizes pain poorly), and is irritating the lining of the peritoneum at the place where the peritoneum comes into contact with the appendix. Tenderness at McBurney’s point suggests the evolution of acute appendicitis to a later stage, and thus, the increased likelihood of rupture. Other abdominal processes can also sometimes cause tenderness at McBurney’s point. Thus, this sign is highly useful but neither necessary nor sufficient to make a diagnosis of acute appendicitis. Also, the anatomical position of the appendix is highly variable (for example in retrocaecal appendix, an appendix behind the caecum), which also limits the use of this sign as many cases of appendicitis do not cause point tenderness at McBurney’s point. For most open appendectomies (as opposed to laparoscopic appendectomies), the incision is made at McBurney’s point.
Location of McBurney’s point (1), located two thirds the distance from the umbilicus (2) to the right anterior superior iliac spine (3).
Surface projections of the organs of the trunk, with McBurney’s point labeled with a red circle at bottom left at the inferior part of the cecum.
Location of McBurney’s point (1), located two thirds the distance from the umbilicus (2) to the right anterior superior iliac spineAnatomy &location
Medical examination: The original test for appendicitis, a simple examination of the belly remains important in making the diagnosis. Changes in the abdominal exam help doctors tell if appendicitis is progressing, as well.
CT scan (computed tomography): A CT scanner uses X-rays and a computer to create detailed images. In appendicitis, CT scans can show the inflamed appendix, and whether it has ruptured.
Ultrasound: An ultrasound uses sound waves to detect signs of appendicitis, such as a swollen appendix.
Complete blood count (CBC): An increased number of white blood cells — a sign of infection and inflammation — are often seen on blood tests during appendicitis.
Other imaging tests: When a rare tumor of the appendix is suspected, imaging exams may locate it. These include magnetic resonance imaging (MRI), positron emission tomography (PET), and CT scans.
Appendectomy: Surgery is the only treatment for appendicitis. The doctor may use the traditional technique (one large cut) or laparoscopy (several small cuts and using a camera to see inside). Surgery is also needed to remove tumors of the appendix. If the tumor is large, it may require more aggressive surgery with removal of part of the colon.
Antibiotics: While the diagnosis is in question, antibiotics treat any potential infection that might be causing the symptoms. In general, antibiotics alone cannot effectively treat appendicitis