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The pain of appendicitis classically is difficult to localize initially, typically centering around the umbilicus. This is accompanied by anorexia, low grade fevers, nausea, and malaise. This generalized pain may last for variable amounts of time, depending on the progression of disease. This generalized pain is caused as the appendix becomes distended. The innervation to the intestines is such that the pain cannot be localized.

Once the appendix becomes inflamed and begins to irritate the peritoneum surrounding it, the pain becomes localized to the right lower quadrant. The pain is worsened by any movement or stretching of the abdominal contents. The hallmark of this is guarding and rebound tenderness. Guarding is an involuntary spasm of the abdominal muscles to prevent movement. Rebound tenderness is increased pain upon release of pressure - this is caused by the "sloshing about" of abdominal contents after pressure is released.

White blood cell count is typically elevated, the urine may have white blood cells in it, as the appendix lies in close approximation to the right ureter and can cause irritation, causing pyuria. Fever is usually higher during this stage. Chills and vomiting may occur.

Computed tomography (CT) with oral and IV contrast may be used to assist with the diagnosis of appendicitis, if it is unclear from history and physical exam. If the symptoms are classic, however, the diagnosis can be made without the need for CT.

The treatment for appendicitis is typically surgical. In specific instances, however, surgeons may elect to treat with intravenous antibiotics and observe for 24-48 hours.

Referred pain can also cause the groin to hurt. I just had appendicitis and had pain around the appendix but more so in the groin area, maily the right portion. I went to my general practitioner who diagnosed me with epididimitis (an infection in a sexual organ). A few days later, a gut-wrenching pain woke me up, and i could not stop shaking. After going to the ER and receiving a CT scan, the doctor informed me that my appendix was on the verge of rupturing, which can be fatal. If your are worried at all about your appendix, get it checked out now.

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15y ago

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