From the Desk of Dr. Ethan Brown, Medical Director of ER Katy
Over 30 years ago when I was in medical school, the professors and textbooks told us how the typical patient with appendicitis presented to the emergency room. After evaluating many patients over the years in the ER, I can tell you that most of my patients did not present to the ER just like the textbooks taught us. While every case is unique and many are not “by the book,” there are still some things to be aware of regarding appendicitis:
What is Appendicitis?
The appendix is a small finger-shaped organ that is attached near the intersection where the small and large intestines come together. The appendix function today is unknown. Some indicate there is no function, other medical professionals believe it acts as a safe house for good bacteria. When the appendix becomes inflamed or infected, it’s called appendicitis.
What are the Symptoms of Appendicitis?
Typically, the pain comes on over hours to a day or two and starts as vague mid-abdominal pain. Eventually, the pain will localize to the right lower quadrant of the abdomen. Patients also often experience fever, nausea/lack of appetite or diarrhea. Elevated white blood cell count can also be a sign of an issue with your appendix.
I had one patient with no symptoms at all except right lower abdominal tenderness. He was sitting up telling jokes, pain free, hungry, without fever and all of his labs and CT scan were normal. No nausea, diarrhea or urinary complaints. But when I touched his right lower abdomen, he would almost jump off of the stretcher in pain. Basically everything was normal except for the tenderness. The surgeon took him to the operating room and found him to have a severely inflamed, enlarged appendix / appendicitis even though his CT scan was normal.
What Happens if Appendicitis Isn’t Treated?
The illness can progress to bowel perforation and even sepsis. Sepsis is a life-threatening medical emergency that occurs when bacteria from any infection (like appendicitis) enters the bloodstream and causes inflammation throughout the body.
Appendicitis vs. Other Illnesses
Many illnesses can present like an appendicitis. Urinary tract infections, kidney infections, kidney stones, cancers, constipation, bowel obstructions, gastroenteritis. diverticulitis, inflammatory bowel disease, etc. can be confused with appendicitis. In women, ovarian cysts or rupture, pelvic inflammatory disease, cancer, torsion, tubal pregnancies, miscarriages, etc. can be confused for appendicitis. Also, children can present much differently than adults with appendicitis and they may have other illnesses altogether like testicular torsion, cancer, epididymo-orchitis, mesenteric adenitis, or intussusception.
Seek Emergency Medical Attention for Appendicitis
The bottom line (no pun intended), if you feel at all that you or a loved one has symptoms that concern you for a possible appendicitis, you should go immediately to the ER for further evaluation and treatment.
At ER Katy, we have the professional expertise to rapidly evaluate patients to determine the cause of the illness and get them the emergent treatment needed right away. We also have the technology needed to rapidly help in this assessment. With the overcrowding seen at many hospital ERs these days, you may be sitting in the ER waiting room for hours before getting seen by a physician. Within minutes of arriving at ER Katy, a CT scan and/or ultrasound will be started and labs drawn with the results back in less than an hour. You don’t want to delay evaluation and care with appendicitis as it can lead to a much worse outcome.
ER Katy is located near the southwest corner of the I-10 and Pin Oak Rd intersection by the H-E-B, and next door to Alicia’s Mexican Grille.
