Diagnosis of Appendicitis

Diagnosis of appendicitis is based on history of the illness (symptoms), physical examination (for finding signs), laboratory investigations and imaging techniques such as Ultrasonography and CT (computerized tomography) scan. History can aid diagnosis of appendicitis if it is typical. Typical history of appendicitis includes abdominal pain that begin in the region of the umbilicus for several hours. The pain around umbilicus is associated with anorexia, nausea or vomiting and the pain then “settles” into the right lower quadrant (iliac fossa), where tenderness develops.

But atypical history of appendicitis can confuse diagnosis and need careful physical examination and laboratory investigations and imaging (Ultrasonography and CT scan). If patient is a woman of childbearing age, pregnancy must be excluded, as ectopic pregnancy can mimic with similar symptoms of appendicitis. If diagnosis of ectopic pregnancy is missed, the consequences are serious and life threatening (may result in death of the patient).

Blood test in appendicitis:

Blood test in appendicitis is not fool proof in diagnosing the disease, as approximately half of the time test may be normal. Usually there is rise in neutrophil white blood cells to more than normal. The normal white blood cell cont is 4-11 thousands per cubic millimeter of blood and in appendicitis the cont goes p above 11,000 with higher percentage of neutrophils.

Urine test in appendicitis:

In most cases of appendicitis, urine test is normal, but may show blood if appendix is rubbing on the bladder. Urine test also must be done in case of women to rule out pregnancy (ectopic pregnancy).

X-ray in appendicitis:

If fecolith is present, plain X-ray may demonstrate hard formed feces in the lumen of the appendix, which may be seen approximately 10% of cases of appendicitis. If fecolith is found in abdominal X-ray, appendix should be removed, because there is high risk of development of complications and worsening of the medical condition. A barium enema contrast X-ray can also be used to diagnose appendicitis.

Imaging techniques Ultrasonography and CT scan for diagnosis of appendicitis are more frequently used these days.

 

 



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