|Early Symptoms of Appendicitis|
Early symptoms of appendicitis are those symptoms that most people with this condition may recognize and complain of.
They include lower right sided abdominal pain of gradual onset, feeling sick (or nausea), and loss of appetite.
Any one with these three symptoms can be assumed to have appendicitis until proven otherwise. We discuss these in more details:
. This pain typically starts from around the belly button (peri-umbilical region), or the upper central abdomen (epigastrium) and then move downwards and to the lower right abdomen (right iliac fossa). When the pain occurs in this pattern, it is the most dependable of all symptoms of appendicitis, as over 8 out 10 (80%) cases that present this way is definitely due to the appendix.
In some other individuals, the pain starts right way from the right iliac fossa. Depending on where the tip of the appendix is, the pain could even be on the right flank (retro-caecal appendix).
If the appendix is quite long, and in the pelvic cavity, it could as well cause lower left abdominal pain, with frequent passage of urine if the inflamed appendix irritates the bladder.
Pain in the scrotum has been reported due to a retro-ileal appendix.
In pregnancy, the pain could be anywhere in the abdomen, due to the uterus displacing the appendix from its normal location.
The pain may be continuous, worsened by movement and reduces on lie still in bed.
When the appendix is severely inflamed, the pain can be localized to a spot on the outer one third of a line drawn between the belly button and front of the tip of the waist bone called the McBurney’s point.
The Mc Burney’s point is also often the point of maximum tenderness when the abdomen is examined.
The pain is even worse when the hand is suddenly removed from that spot because of the appendix rubbing on the covering of the abdomen (Rebound tenderness).
There is also a sign referred to as the Rovsign sign. This is said to exist when the lower left abdomen is palpated by the doctor, but causes pain in the right.
If the appendix is the pelvic type, examining the back passage (rectal examination) would cause some pain too.
If the hip is moved and stretched, this can also cause pain to be felt at the spot where the appendix lies. This is referred to as the psoas sign.
In about 9 of 10 (90%) individuals with appendicitis would have a feeling of wanting to be sick or vomit (nausea)... another very important symptoms of appendicitis.
They may actually vomit. It is important to note that vomiting in appendicitis usually follows the pain. If you vomit before the pain commenced, it is not likely that the appendix is to blame.
In adults, the appendix can rest on the bladder wall on rare occasions and cause irritation of the bladder. This may present as a patient with the signs and symptoms of appendicitis, as well as passing urine frequently. There may be blood in the urine of such ones.
|Early Signs of Appendicitis|
. This is said to occur when the abdominal wall becomes rigid during examination. It occurs when ever there is peritonitis, localized as in appendicitis, or even in generalized peritonitis.
There are two forms of guarding – Voluntary and Involuntary. Voluntary guarding is said to occur when a patient visibly contracts the muscles of the wall of the abdomen during examination to prevent the examiner pressing deep into the abdomen. The muscle can be seen to relax once the examiner removes his or hands.
Involuntary guarding is a reflex spasm of the muscles of the abdominal wall, and is not within the control of the patient. The abdomen remains rigid even after examination, and this may be seen as an abdomen that does not move with respiration. Abdominal rigidity or involuntarily guarding is a very bad sign and may indicate a perforated appendicitis.
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