If you suddenly feel severe abdominal pain, it is most likely ‘appendicitis’. It is important to see a doctor as soon as possible because appendicitis can cause serious sequelae if emergency abdominal surgery is not performed immediately after symptoms appear. However, in the early stages of appendicitis, it is often confused with simple abdominal pain or enteritis and misses the treatment time.
It mainly appears in the younger generation… Delaying surgery can lead to complications
Food ingested through the mouth passes through the esophagus, stomach, small intestine, and large intestine, and the remaining waste products are discharged through the anus. Among them, there is a digestive system called the cecum in the part from the small intestine to the large intestine. The cecum plays the role of absorbing the water and salt remaining in the food after digestion and absorption in the small intestine and mixing the contents with the mucus. At the end of the cecum, there is a small pouch-shaped appendix with a length of 6 to 9 cm. The appendix functions to cultivate beneficial intestinal bacteria that the digestive system needs when the number of bacteria in the large intestine decreases. When the inside of the appendix is blocked due to various causes, such as excessive proliferation of lymphatic tissue around the appendix or hard stools flowing into the appendix and blocking the entrance, normal intestinal peristalsis from the appendix to the large intestine is restricted. Just as stagnant water quickly rots, intestinal bacteria multiply and secrete toxic substances in the appendix where retention occurs. As a result, the mucous membrane inside the appendix is damaged and an ulcer is formed, resulting in acute appendicitis.
If left untreated when appendicitis occurs, pus from the appendix may flow out and cause complications such as peritonitis. If surgery is not performed within 3 days of the onset of symptoms, the risk of complications increases. In case of acute appendicitis, surgery should be performed within 24 hours. However, surgery is often delayed because appendicitis is not recognized sooner than expected. According to the ‘Clinical Characteristics of Acute Appendicitis in Children and the Elderly’ published by Seoul Red Cross Hospital Surgery in 2011, 1,286 appendectomy patients were surveyed by age. The adult group accounted for 18.3% and the elderly group accounted for 43.8%. As the age increased, the operation time was delayed, which seems to indicate that the elderly did not recognize appendicitis because the symptoms did not appear well and the pain was not severe. Therefore, the older you are, the more you need to pay attention to even the smallest symptoms.
Pain should be checked when pressing and releasing the ‘right lower abdomen’
In the early stages of appendicitis, it may be difficult to distinguish it from other digestive diseases because the upper stomach or the medius region is subtly painful. At the onset of appendicitis, there is a loss of appetite, followed by nausea, followed by pain in the upper abdomen. At this time, he vomits about 1 or 2 times, and there is no abnormality in the right lower abdomen where the appendix is located, or only a little pain when pressed with a hand during examination, so it is easy to think that he is just pretending.
However, over time, the pain passes through the navel and changes to pain in the lower right abdomen. Also, when the right knee is bent, the pain is reduced, and when the knee is straightened, the excruciating pain is felt. This is because the rotator cuff muscles are stimulated due to inflammation of the appendix and when the right hip is bent, the pain in the lower right abdomen is less. In addition, Dr. Sang-min Yoon (Central Clinic), a surgical consultant at Hidak, explained in a Q&A of Hidak, “If appendicitis worsens, strong tenderness, fever accompanied by chills, and general pain in the abdomen may occur.”
Help = Dr. Sangmin Yoon (Surgery Specialist at the Joongang Atomic Surgery Clinic)