This video shows Inflamed Appendix.
It is generally accepted that the main etiology of appendicitis is obstruction due to fecalith in adults and lymphoid hyperplasia in children. It is also accepted that perforated/gangrenous appendicitis is associated with an obstructed appendix secondary to the presence of a fecalith.
The most useful sign of acute appendicitis on ultrasonography is an outer appendiceal diameter of 6 mm or greater on cross-section. Depending on the technique used, the diagnostic accuracy of CT in acute appendicitis ranges from 93 to 98 percent.
Sometimes stool can get stuck in the appendix, which is shaped like a tube with one closed end. Like a balloon that's been tied off, there's no way for what's trapped inside to escape. The pressure builds as the appendix continues producing its normal secretions.
Infection is one of the most common causes of appendicitis. A viral or bacterial infection causes the appendix to swell and fill with pus. The inflammation blocks blood flow to the appendix, which then starts to die. At this point, the appendix can develop holes or tears or may even burst if it is not treated.
Appendicitis can be acute or chronic. In acute cases of appendicitis, the symptoms tend to be severe and develop suddenly. In chronic cases, the symptoms may be milder and may come and go over several weeks, months, or even years.
Appendicitis symptoms may last between 36 to 72 hours before the appendix ruptures. Appendicitis symptoms develop quickly from the onset of the condition. Early symptoms include pain near the belly button, loss of appetite, nausea, and vomiting, and a low fever.
There's no way of knowing when or if appendicitis will occur, so you can't prevent it. However, you can avoid a rupture if appendicitis is treated right away. The key is to be aware of the symptoms of appendicitis. If you develop them, seek medical attention immediately.
The most telltale symptom of appendicitis is a sudden, sharp pain that starts on the right side of your lower abdomen. It may also start near your belly button and then move lower to your right. The pain may feel like a cramp at first, and it may get worse when you cough, sneeze or move.
Upset stomach and vomiting. Loss of appetite. Fever and chills. Trouble having a bowel movement (constipation).
Symptoms of Appendicitis
Pain in your lower right belly or pain near your navel that moves lower. This is usually the first sign.
Loss of appetite.
Nausea and vomiting soon after belly pain begin.
Swollen belly.
Fever of 99-102 degrees.
Can't pass gas.
The pathophysiology of acute appendicitis usually involves appendiceal obstruction with continued mucinous fluid secretion and bacterial proliferation within the lumen of the appendix. As such, a fluid- or mucus-filled appendix is recognized as a sign of acute appendicitis at CT.
Most often, health care professionals suspect the diagnosis of appendicitis based on your symptoms, your medical history, and a physical exam. A doctor can confirm the diagnosis with an ultrasound, x-ray, or MRI exam.
Sonographic criteria for a diagnosis of appendicitis include a noncompressible, blind-ended, aperistaltic tubular structure in right lower quadrant arising from the base of the cecum.
The appearance is hyperechoic with an echo-poor abscess surrounding the appendix. There may be a reflective omentum around the appendix, a thickened bowel, and enlarged lymph nodes. Asymmetrical wall thickening may indicate a perforation.
An ultrasound examination is performed to evaluate for Appendicitis. Graded compression ultrasound of the right lower quadrant will reveal a non-compressible, enlarged appendix. If the bowel wall layers, particularly the echogenic submucosa, are lost, it is suggestive of perforation.
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