Appendicitis is inflammation of the appendix, usually from a blockage. Without treatment it can burst and cause peritonitis.
Key symptoms
- Pain that starts around the navel and moves to the lower right abdomen
- Loss of appetite, nausea, vomiting
- Low-grade fever
What you find on exam
- Tenderness at the lower right abdomen
- Guarding and pain on release (rebound)
- Pain in the right lower abdomen when pressing the left side
- Signs of peritonitis if it has burst: rigid belly
Tests
- Blood count: high white cells
- Pregnancy test in anyone who could be pregnant
- Ultrasound (children, pregnancy) or CT scan
Treatment basics
- Nothing by mouth, IV fluids, pain relief
- Antibiotics
- Surgery to remove the appendix in most patients
Red flags
- Rigid abdomen
- Fever with fast heart rate or low blood pressure
- Pain in pregnancy
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.