Appendicitis

Dr. Sulaiman Bin Yusof

MbChB (Sheffield) M.Med (Surg) FRCSEd (Gen Surg)
蘇萊曼·尤索夫博士

Appendicitis is the inflammation of the appendix, a small pouch connected to the large intestine. It typically results from a blockage caused by hardened stool, swollen lymphoid tissue, foreign bodies, or infections in the digestive tract.

Without treatment, the inflamed appendix may rupture, leading to severe complications. Surgical removal of the appendix (appendectomy) is the definitive treatment since the condition does not resolve on its own.

Symptoms of Appendicitis

Appendicitis symptoms usually appear quickly, often developing within hours. Common signs include:

Abdominal Pain: The pain usually begins around the belly button and moves to the lower right side of the abdomen. It worsens with movement, coughing, or sneezing.

Nausea and Vomiting: Many people experience nausea and vomiting, often accompanied by loss of appetite, as the body reacts to the inflammation.

Fever: As the body fights the infection, a low-grade fever may develop, which may be accompanied by chills or sweating.

Digestive Symptoms: Constipation, diarrhoea, or difficulty passing gas may indicate possible digestive blockages caused by the inflamed appendix.

Abdominal Tenderness and Swelling: The lower right side of the abdomen may become tender and swollen, making touching or pressing on it painful.

Causes of Appendicitis

The primary cause of appendicitis is appendix blockage, which causes inflammation and infection. Contributing factors include:

Obstruction by Stool (Fecolith)

Hardened stool can block the appendix, trapping bacteria and preventing drainage, resulting in infection.

Lymphoid Tissue Swelling

Lymphoid tissue in the appendix can swell during infections such as gastrointestinal illnesses, blocking the appendix.

Digestive Tract Infections

Infections can cause lymph nodes near the appendix to swell, increasing pressure and blockage, potentially worsening the condition.

Diagnosis of Appendicitis

Appendicitis is diagnosed through a combination of physical exams, patient history, and diagnostic tests.

Physical Examination

The doctor presses on the abdomen, focusing on the lower right side to identify areas of tenderness. Rebound tenderness or pain that worsens after pressure is released is a key indicator of appendix inflammation.

Patient History

The doctor asks about the pain onset, location, and nature of the pain, along with other symptoms such as nausea, vomiting, or loss of appetite. This information helps determine whether the symptoms match the pattern of appendicitis.

Blood Tests

A Complete Blood Count (CBC) is often used to help diagnose appendicitis by checking for an elevated white blood cell count, indicating infection or inflammation.

Imaging Tests

Ultrasound, CT scans, or MRIs are performed to confirm inflammation and check for complications like abscesses or rupture. These tests also help rule out other potential causes of abdominal pain, such as ovarian cysts or kidney stones.

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Treatment for Appendicitis

The primary treatment for appendicitis is surgical removal of the appendix to prevent rupture and complications.

Surgical Treatment
Laparoscopic Appendectomy

This minimally invasive procedure involves making small incisions in the abdomen and using a camera (laparoscope) to guide the removal of the appendix. It typically results in less post-operative pain, smaller scars, and a quicker recovery compared to open surgery. Laparoscopic appendectomy is often preferred for uncomplicated cases of appendicitis.

Open Appendectomy

In cases where the appendix has ruptured, a larger incision is made to access and remove the appendix. This method allows the surgeon to clean the abdominal cavity thoroughly, reducing the risk of further infection. Recovery from open appendectomy takes longer due to the more extensive nature of the surgery.

Abscess Drainage

If the appendix has ruptured and an abscess has formed, the abscess is drained using a needle or tube under imaging guidance. Antibiotics are given to control the infection, and surgery to remove the appendix is performed after the infection resolves. This two-step approach prevents complications from operating during active infection.

Non-Surgical Treatment

In mild cases of appendicitis, antibiotics may be used to manage infection and reduce inflammation. This approach can sometimes delay or avoid surgery, but there is a risk of recurrence, making it more suitable for patients who are not immediate surgical candidates.

Preventing Appendicitis

While appendicitis cannot be entirely prevented, maintaining a healthy lifestyle may lower the risk. Eating fibre-rich foods, staying hydrated, and exercising regularly can promote digestive health and prevent constipation, which may reduce the chance of blockage in the appendix.

However, although a healthy lifestyle lowers the risk, appendicitis can still occur unexpectedly.

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Dr. Sulaiman Bin Yusof

MbChB (Sheffield)

M.Med (Surgery)

FRCSEd (General Surgery)

蘇萊曼·尤索夫博士

Dr. Sulaiman Yusof is a distinguished Senior Consultant in colorectal and general surgery, boasting over 15 years of expertise. His passion lies in minimally invasive techniques, particularly robotic surgery, where he has achieved remarkable success using the Da Vinci Xi system. Dr. Sulaiman is dedicated to delivering high-quality, personalized, and empathetic care, always striving for the best outcomes for his patients.

Education & Specialist Training
  • MbChB(Sheffield)
  • M.Med(Surgery)
  • FRCSEd(General Surgery)

Dr. Sulaiman’s journey began at the University of Sheffield, where he graduated in 2002. He honed his skills during his house officer and basic surgical training in the UK before returning to Singapore. There, he completed his Advanced Surgical Training at Changi General Hospital and earned the Joint Speciality Fellowship in General Surgery in 2013.

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    Frequently Asked Questions

    Can appendicitis recur if the appendix is not removed?

    Yes, appendicitis can recur if the appendix is not surgically removed, especially in cases managed only with antibiotics. Surgery is generally recommended to prevent future episodes.

    How long does it take to recover from an appendectomy?

    Recovery varies based on the type of surgery. Laparoscopic appendectomy patients typically resume normal activities within 1 to 3 weeks, while open surgery patients may need 4 to 6 weeks due to the larger incision and longer healing process.

    Are there any long-term effects of having the appendix removed?

    The appendix is not essential, and its removal does not affect digestion or long-term health. In rare cases, adhesions (scar tissue) may develop post-surgery, but most individuals recover fully without lifestyle restrictions.

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