Diagnostic Criteria for Appendicitis and Risk of Ruptured Appendix

Dear Ask The Doctor: How is appendicitis diagnosed and differentiated from other casues of lower abdominal pain? What is the best imaging test to verify appendicitis? What are the indications for surgery? I have heard if surgery is delayed, your appendix xould "rupture". What would they do if your appendix ruptured? Would they still perfrom surgery or would they do something else?

Dear Suneel: Appendicitis is diagnosed based on the symptoms and examination findings. The symptoms are pain around the navel which then moves to the right lower abdomen, nausea, loss of appetite, fever, and vomiting. It is differentiated from other causes of abdominal pain based on the symptoms and a thorough examination by a doctor. Occasionally, even after a thorough examination, the diagnosis may still be in doubt. A CT scan may be used to confirm the diagnosis.

Surgery is always indicated when appendicitis is diagnosed. If left untreated the appendix could rupture. A ruptured appendix is a serious condition which also requires surgery. Sometimes the appendix may rupture but be “walled off” by surrounding organs. When this occurs, a course of antibiotics is usually administered followed by surgery 4-6 weeks later.