Appendicitis

Diagnosis

To help diagnose appendicitis, your health care professional will likely take a history of your symptoms and examine your belly (abdomen).

Tests and procedures used to diagnose appendicitis include:

• Physical exam to assess your pain. Your health care professional may apply gentle pressure on the painful area. When the pressure is suddenly released, appendicitis pain will often feel worse, suggesting that the peritoneum is inflamed.
• Blood test. This allows your health care professional to check for a high white blood cell count, which may indicate an infection.
• Urine test. Your health care professional may want you to have a urinalysis to make sure that a urinary tract infection or a kidney stone isn't causing your pain.
• Imaging tests. Your health care professional may also recommend a CT scan of the belly to confirm appendicitis or find other causes for your pain. Ultrasound may be used in children or people who are pregnant.

More information

Your health care professional may recommend the following tests and procedures:

• CT scan
• Ultrasound
• Urinalysis

Treatment

Appendicitis treatment usually involves surgery to remove the inflamed appendix. Before surgery, you may be given a dose of antibiotics to treat infection.

Surgery to remove the appendix (appendectomy)

Appendectomy can be performed as open surgery using one cut (incision) in the belly (abdomen) about 2 to 4 inches (5 to 10 centimeters) long, known as a laparotomy. Or the surgery can be done through a few small incisions in the abdomen, known as a laparoscopic surgery. During a laparoscopic appendectomy, the surgeon inserts special surgical tools and a video camera into the belly to remove the appendix.

In general, laparoscopic surgery allows you to recover faster and heal with less pain and scarring. It may be better for older adults and people who have obesity.

But laparoscopic surgery isn't appropriate for everyone. If your appendix has burst and infection has spread beyond the appendix, or you have an abscess, you may need an open appendectomy. An open appendectomy allows your surgeon to clean the abdominal cavity.

Draining an abscess before appendix surgery

If the appendix has burst and an abscess has formed around it, the abscess may be drained by placing a tube through the skin into the abscess. Appendectomy can be performed several weeks later after the infection is controlled.

Antibiotics

Before surgery, you'll be given antibiotics to fight infection. In some cases of mild appendicitis, antibiotics alone may be used as treatment. But this is not common practice.