What should you know about appendicitis?

What is appendicitis?  It is when the appendix (a little vestige/outpouching/diverticulum of the intestine where the small and large intestine attach) gets inflamed.

What is the lifetime risk of appendicitis?  10%

What are the classic symptoms: abdominal pain near the belly button which then migrates to the right lower quadrant, loss of appetite, vomiting, nausea, fever, and elevated white blood cell count. 

Why is appendicitis important?  If your appendix is inflamed it can rupture and spew stool and bacteria into your abdomen.  This can cause sepsis and death.

What are your options?  If you have abdominal pain that worsens and does not let up, you should go to the emergency department (not urgent care).  Serial physical exams will be performed which lets the physician know if your symptoms are easing up or worsening. 

What is the imaging that may be done?  There was a compilation of studies that totaled more than 10,000 patients.  CT scan is a good screening test with 95% sensitivity (missing 5% of the cases) and 94% specificity(so if the CT shows you have appendicitis there is a VERY good chance you actually have it).  Unenhanced, standard-dose CT scan was a little less likely to show appendicitis compared to standard-dose CT WITH rectal, intravenous or oral contrast enhancement.  Because of these findings the American College of Radiology Appropriateness Criteria for right lower quadrant pain with suspected appendicitis gives abdominal and pelvic CT with IV contrast the highest rating and abdominal and pelvic CT without IV contrast the middle rating.