What are the usual history and symptoms of appendicitis?
Pain, often (but not always) occurs initially in the central abdomen and later migrates to the right lower abdomen. Loss of appetite is a very common associated symptom. Nausea and vomiting can frequently occur with acute appendicitis. Unfortunately, not everyone has the typical symptoms of appendicitis.
What causes appendicitis?
For most individual cases, the specific cause is not usually identified. However, appendicitis most often develops when a part of the appendix becomes blocked. Blockage often is from a hard piece of stool (a fecalith) or sometimes (especially in children) from enlarged lymph nodes. Tumors and intestinal worms are more rare causes of blockage of the appendix and subsequently appendicitis.
Tenderness on examination of the right lower abdomen is also an important finding that is often present with appendicitis. Blood test and often either an ultrasound or CT scan of the abdomen are sometimes done to assist with the diagnosis. The history, exam and tests are all used to assist in making the diagnosis.
The standard treatment for appendicitis is removal of the appendix, either laparoscopially (with a few "keyhole" incisions) or with the classical "open" appendectomy.
Usually this surgery is done fairly soon after diagnosis, but sometimes an "interval" appendectomy (that is, several weeks after diagnosis) may be performed in some instances of perforated (i.e., ruptured) appendicitis.