How does appendicitis develop and how long does it last?

The article was written by Doctor Ngo Viet Thang - Gastroenterologist, Department of General Surgery, Vinmec Ha Long International General Hospital.

Appendicitis progresses very quickly, can rupture, necrosis, making it difficult to treat and easily lead to complications such as enteritis, intestinal obstruction, endangering the life of the patient.

The appendix is ​​a thumb-sized organ located on the lower right side of the abdomen, sealed at one end and connected to the cecum (first segment of the large intestine). Appendicitis is an inflammation of the appendix. The cause of appendicitis is mainly due to bacterial infection when the lumen of the appendix is ​​blocked by the hyperplasia of the lymphoid tissue in the wall of the appendix or by fecal stones, parasites, fruit seeds, ... entering the intestines. redundant.

Appendicitis pain is the first and always-present symptom of appendicitis. How long appendix pain lasts depends mainly on the condition of each person. Usually the pain comes on very quickly. At the onset of appendicitis, patients often have appendicitis pain lasting 1-12 hours, mainly pain in the right side of the abdomen, the area around the navel and the epigastrium. Next, the pain gradually moved to the lower abdomen next to the right iliac fossa. At this time, the pain will be dull, sometimes the pain increases, making the patient very uncomfortable.
After the pain appears, other symptoms of appendicitis will also manifest within 24 hours. Approximately 65% ​​of patients with appendicitis develop complications of rupture after 48 hours. Therefore, if the patient has severe abdominal pain accompanied by signs of appendicitis such as fever, digestive disorders, etc., it is necessary to go to the hospital immediately for timely diagnosis and emergency treatment.

When a patient with appendicitis is not diagnosed and treated promptly it can progress in the following ways:
3.1 Appendiceal mass The inflamed appendix is ​​surrounded by the great omentum and surrounding structures. Clinically, the function will gradually decrease, there is no fever, the patient feels better or the abdominal pain is gone. On clinical examination of the right iliac fossa, a hard, cardboard-like patch with indistinct boundaries is seen. It is sometimes difficult for doctors to distinguish between appendiceal masses and appendiceal abscesses. Appendiceal clumps can develop in two ways: either gradually dissolve, the patient has less pain, reduce inflammation, or form an appendix abscess.

3.2 Appendiceal Abscess Acute appendicitis bursts with pus surrounded by nearby organs such as the great omentum, small intestine, forming a localized fossa of pus called an appendix abscess. Appendiceal abscess formation time is about 4-5 days. On physical examination, the doctor felt a mass in the right iliac fossa, poor mobility, very painful when pressed, and there was a reaction to the abdominal wall. 3.3 Peritonitis Appendicitis ruptured purulent purulent partially enclosed or unencapsulated causing pus to spread to part or all of the abdominal cavity causing localized or generalized peritonitis. May be localized to the right iliac fossa, lower half of the abdomen or total peritonitis. Appendicitis often occurs when patients are diagnosed with late appendicitis. Common clinical symptoms are: the patient has a lot of pain in the right iliac fossa, a high fever over 39 degrees Celsius, abdominal distention, and bowel obstruction. On clinical examination, the patient presented with pain in the right iliac fossa or throughout the abdomen. When experiencing abdominal pain, especially pain in the right iliac fossa with fever, suspected of appendicitis, the patient should immediately go to the hospital for early detection, diagnosis and timely surgical intervention to prevent. symptoms.