Diagnosis and management of appendiceal disease

  The appendix is a tubular organ attached to the posterior medial wall of the cecum. Its distal end is blind, so when the appendiceal cavity is blocked by proliferating lymphoid follicles or fecal stones, it can easily lead to bacterial multiplication in the appendiceal cavity and secondary infection, resulting in acute appendicitis. The appendiceal artery is the terminal artery, which can lead to appendiceal necrosis and perforation when blood flow is impaired. The typical clinical manifestations of acute appendicitis include metastatic right lower abdominal pain, nausea, vomiting, and fever, which is manifested as pressure pain in the right lower abdomen on physical examination.  Early surgical treatment is the main and most effective treatment for acute appendicitis. If surgery is not performed in a timely manner, the inflammation of the appendix may cause appendiceal necrosis and perforation due to blood flow disorders in the appendix, and then complications such as abdominal abscess, internal and external fistula, and portal phlebitis may occur. Therefore, in most cases of appendicitis, appendectomy should be performed early once the diagnosis is confirmed.  The main surgical procedure is appendectomy, which is easier and has fewer postoperative complications when the appendiceal inflammation is still in the lumen obstruction or when there is only congestion and edema.