Appendicitis natural history, complications and prognosis: Difference between revisions
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==Natural History== | ==Natural History== | ||
The symptoms of appendicitis typically develop shortly after the [[inflammation]] of the [[appendix]]. Without treatment, the patient will likely develop symptoms of [[pain]] starting centrally (periumbilical) before localizing to the [[right iliac fossa]] | The symptoms of appendicitis typically develop shortly after the [[inflammation]] of the [[appendix]]. Without treatment, the patient will likely develop symptoms of [[pain]] starting centrally ( in the periumbilical region) before localizing to the [[right iliac fossa]] in the right lower quadrant of the abdomen. They will also experience [[loss of appetite]], [[diarrhea]], [[fever]], [[nausea]], and [[vomiting]]. During the final stage of the untreated disease process, the appendix will rupture, and this may eventually lead to death if [[peritonitis]] develops. | ||
==Complications== | ==Complications== |
Revision as of 16:33, 14 August 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
If left untreated, appendicitis can lead to death if peritonitis develops from the rupturing of the appendix. Acute appendicitis that is evaluated and treated early with an appendectomy generally leads to no further complications and to a full recovery of the patient.
Natural History
The symptoms of appendicitis typically develop shortly after the inflammation of the appendix. Without treatment, the patient will likely develop symptoms of pain starting centrally ( in the periumbilical region) before localizing to the right iliac fossa in the right lower quadrant of the abdomen. They will also experience loss of appetite, diarrhea, fever, nausea, and vomiting. During the final stage of the untreated disease process, the appendix will rupture, and this may eventually lead to death if peritonitis develops.
Complications
In cases of acute appendicitis, life-threatening peritonitis can occur if the appendix bursts. It is for this reason that appendicitis cases are evaluated and treated speedily.
Prognosis
- Most appendicitis patients recover easily with treatment, but complications can occur if treatment is delayed or if peritonitis occurs.
- Recovery time depends on age, condition, complications, and other circumstances, including the amount of alcohol consumption, but usually is between 10 and 28 days. For young children (around 10 years old) the recovery takes three weeks.
- Typical acute appendicitis responds quickly to appendectomy and occasionally will resolve spontaneously.
- If appendicitis resolves spontaneously, it remains controversial whether an elective interval appendectomy should be performed to prevent a recurrent episode of appendicitis.
- Atypical appendicitis (associated with suppurative appendicitis) is more difficult to diagnose and is more apt to be complicated even when operated early.
- In either condition prompt diagnosis and appendectomy yield the best results with full recovery in two to four weeks usually.
- Mortality and severe complications are unusual but do occur in cases of appendicitis, especially if peritonitis persists and is untreated