Another appendicitis

Description of the Disease

Chronic appendicitis is a long-lasting or constantly recurring inflammation of the vermiform appendix.

The vermiform appendix is an 8-9 cm extension of the cecum. The cecum is the initial part of the colon located in the lower right abdomen. The exact function of the vermiform appendix in the body is not fully understood. It is believed to be important for the immune system.

Chronic appendicitis is a very rare condition. At one point, it was even believed that this condition did not exist at all. However, despite long discussions, the diagnosis was decided to be retained. It is believed that this condition is a long path leading to the development of acute appendicitis.

Cause of the Disease

Appendicitis occurs due to the obstruction of the vermiform appendix lumen, which is caused by the accumulation of mucus or intestinal contents, sometimes intestinal infections. During chronic appendicitis, the inflammatory process develops over a long period, several months or even years. Chronic appendicitis can result from untreated acute appendicitis for various reasons (clinically nonspecific, the person did not seek medical attention).

Symptoms

A variety of clinical symptoms characteristic of chronic appendicitis are described. Just because of their diversity, it is very difficult to diagnose the disease. Typically, the pain in the lower right abdomen, which is characteristic of acute appendicitis, is not typical for chronic appendicitis. Often at the onset of this condition, there is discomfort or mild pain felt almost all over the abdomen, usually around the navel. For this reason, various diseases may be sought or the symptom may simply be attributed to worsened digestion. The pain recurs periodically, becoming increasingly bothersome. Severe pains in the lower right abdomen usually occur only after a long time. During chronic appendicitis, there may also be loss of appetite, nausea, episodes of constipation, or diarrhea.

Diagnosis

Diagnosing chronic appendicitis is very difficult. Usually, it is identified after ruling out various other gastrointestinal or other organ system diseases (e.g., in women, lower right abdominal pain may be related to ovarian pathology).

Treatment

Once chronic appendicitis is diagnosed, a scheduled appendectomy operation (removal of the vermiform appendix) is recommended.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology