How is appendicitis diagnosed?

A doctor may diagnose appendicitis quite easily if you have the typical symptoms. However, as described above, not everyone has typical symptoms. Sometimes it is difficult for doctors to be sure that appendicitis is the cause of the symptoms. Some people develop pain that is similar to appendicitis, but which is caused by other conditions. For example, a urine infection. Some people have surgery only to find that the appendix is normal and not inflamed. There is no easy and foolproof test to confirm appendicitis. A surgeon often has to make a judgement whether to operate or not. It depends on whether the symptoms suggest that appendicitis is the probable diagnosis. Sometimes a surgeon advises to 'wait and see' for a few hours or so. This allows some time to see if symptoms progress to a more definite diagnosis, or if they change or go away. Sometimes tests are used if there is doubt about the diagnosis. For example, an ultrasound scan or a CT scan may help to clarify the cause of the symptoms in some cases. But doing tests takes time and may get in the way of doing prompt surgery, which is often the top priority (see below).

What is the treatment for appendicitis?

You will be admitted to hospital if appendicitis is suspected. An operation to remove the inflamed appendix is usually done quite quickly once the diagnosis is made. It is much better to remove an inflamed appendix before it bursts. The inflamed appendix is found and cut off the caecum. The 'hole' left in the caecum is stitched up to stop any contents from the gut leaking out. Removal of the appendix is one of the most commonly performed operations in the UK. In most cases, the operation is done before the appendix perforates. This is usually a straightforward and successful operation needing just a short recovery. However, surgery can be more difficult and you will take longer to recover if the appendix has perforated. There are usually no long term complications after the operation. As with any operation there is a small risk of complications from the operation itself and from the anaesthetic. However, if you don't have an operation, an inflamed appendix is likely to perforate and cause a serious infection in the abdomen (peritonitis) which can be life-threatening.

References

• L Santacroce and T Losacco. Appendicitis. eMedicine. Article dated September 12 2006
• Beasley SW Can we improve diagnosis of acute appendicitis BMJ 2000;321:907-908; [Editorial]
• Benjamin IS and Patel AG. Managing acute appendicitis. BMJ 2002;325:505-506; [Editorial]

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© EMIS and PiP 2007 Updated: 9 May 2007 DocID: 4564 Version: 38

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