Where is the appendix?

Which side is the appendix on? In most patients, the appendix is ​​located in the lower right side of the abdomen. Due to congenital malposition of the intestine, a small number of patients are also called "mirror people". The internal organs are located opposite to those in a normal person, with the appendix located in the lower left abdomen. In addition, some patients present with symptoms of left appendicitis in appendicitis due to large visceral freedom and adhesion of the appendix to the left lower abdomen. In the early stages of typical appendicitis, there is pain in the upper abdomen or umbilicus. After a few hours, the abdominal pain shifted and became fixed in the right lower abdomen.

Typical symptoms of appendicitis include:

l. Pain in the right lower abdomen;

2. Nausea and vomiting;

3. Constipation or diarrhea;

4. Low-grade fever;

5. Loss of appetite and abdominal distension, etc.

The abdominal pain of appendicitis usually starts in the upper abdomen, under the xiphoid process or around the navel. After about 6-8 hours, the pain gradually moves downward and finally fixes in the lower right abdomen. Pain in the right lower abdomen when coughing, sneezing or pressing. If you have the above symptoms, you should see a doctor immediately and do not take it lightly.

Bacterial infection and obstruction of the appendix cavity are the two main factors for the occurrence of appendicitis. The appendix is ​​a long, thin blind tube with a narrow lumen, which easily retains feces and bacteria from the intestinal cavity. The wall of the appendix is ​​rich in nerve devices (such as muscular nerve plexuses, etc.), and the root of the appendix has a sphincter-like structure, so it is easy to contract and make the lumen narrower when stimulated. The appendicular artery is the terminal branch of the ileocolic artery and is a terminal artery. Therefore, when it contracts or is blocked due to stimulation, it often causes ischemia or even necrosis of the appendix. Appendicitis is caused by bacterial infection, but there is no specific pathogen. Escherichia coli, enterococci and streptococci can usually be found in the appendix cavity, but these bacteria can only invade and cause appendicitis after the appendix mucosa is damaged. The appendix cavity may be mechanically blocked by fecal stones, parasites, etc., or it may cause appendix spasm due to various stimuli, causing blood circulation disorders in the appendix wall and causing mucosal damage, which is conducive to bacterial infection and causes appendicitis. [4]

Special PopulationsAppendicitis

Acute appendicitis in children

Acute appendicitis in children develops rapidly, is severe, has a high perforation rate, and has many complications. Almost 100% of acute appendicitis in infants under one year old will result in perforation, 70%-80% under two years old, and 50% under five years old. The mortality rate of acute appendicitis in children is 2%-3%, which is 10 times higher than that in adults. Furthermore, children are often uncooperative during examinations, and it is difficult to determine the extent and extent of abdominal tenderness. After the diagnosis is confirmed, the appendix should be removed surgically immediately, and preoperative preparation and postoperative comprehensive treatment should be strengthened to reduce complications.

Acute appendicitis in the elderly

With the aging of my country's population, the incidence of acute appendicitis in people over 60 years old has increased. The elderly often suffer from various major organ diseases such as coronary heart disease. The mortality rate of acute appendicitis is high and increases with age. The elderly have low resistance, thin appendix walls, and hardened blood vessels. About 1/3 of patients have a perforated appendix when they seek medical treatment. In addition, the elderly have low reaction ability, no obvious abdominal tenderness, and atypical clinical manifestations. Because the abdominal muscles have atrophied, even if appendicitis has perforated, the abdominal tenderness is not obvious, which can easily lead to misdiagnosis.