When to Seek Urgent Care
Seek emergency care for severe or steadily worsening abdominal pain, especially if it moves to the lower right side or occurs with fever, repeated vomiting, faintness or a swollen, rigid abdomen. Do not take laxatives or wait for the pain to settle.
Understanding the Condition
The appendix is a small tube attached to the first part of the large bowel. When it becomes blocked and inflamed, pain often starts near the navel and later moves to the lower right abdomen. Nausea, loss of appetite, vomiting, fever, diarrhoea or constipation may occur.
The pattern can differ in children, older adults and pregnancy. Without treatment, the appendix may burst and cause an abscess or widespread infection in the abdomen.
How It Is Assessed
The team combines your symptoms, abdominal examination, temperature, pulse, blood tests and urine test. Ultrasound is often used in children, younger adults and pregnancy. CT is usually more accurate in adults when the diagnosis remains uncertain. Other bowel, urinary and gynaecological conditions can cause similar pain.
When Is Surgery Considered?
Appendicectomy is the standard treatment for most patients who are fit for an operation. Surgery is more urgent when there is a suspected burst appendix, widespread infection or worsening illness.
Antibiotics alone may be discussed for selected adults with scan-confirmed uncomplicated appendicitis and no appendicolith, which is a hard deposit in the appendix. Symptoms may fail to settle or return, and surgery may still be needed. A localised abscess sometimes requires antibiotics and image-guided drainage before any planned operation.
Surgery and Important Risks
Most appendicectomies are performed laparoscopically through small incisions under general anaesthesia. The surgeon inspects the abdomen, seals the appendix at its base and removes it in a protective bag. Open surgery may be safer when infection is extensive, anatomy is difficult or another problem is found.
Risks include bleeding, wound infection, an abscess inside the abdomen, injury to bowel or urinary structures, blood clots and conversion to open surgery. Risk and hospital stay are usually greater after a burst appendix or delayed presentation.
Recovery and Follow-up
Many patients with uncomplicated appendicitis go home within one or two days. Complicated infection may require a longer stay and further antibiotics. Walking, fluids and a gradual return to normal food begin early.
Follow advice about dressings, bathing, driving, lifting and work. Contact the team for increasing pain, persistent vomiting, fever, wound redness or pus, abdominal swelling, or inability to pass stool or gas. The laboratory report on the removed appendix should be reviewed.