To recognize appendicitis when it occurs, one must already know what it means. We asked Dr. Emilie Duchalais, a visceral, colorectal and proctologic surgeon at the University Hospital of Nantes, to tell us more about appendicitis.

Appendicitis, what is it?

"Appendicitis is an inflammation and / or infection of the appendix, which is a tubular formation of 5 mm in diameter and 3 to 10 cm long abbot in the right colon," says Dr. Duchalais. When it comes to simple appendicitis , inflammation only affects the appendix. On the other hand, when appendicitis is complicated , the inflammation can extend to the peritoneum , the envelope of all organs of the abdomen. "This is called appendiceal peritonitis ."

What are the symptoms ?

"Appendicitis is characterized by abdominal pain , classically located in the right iliac fossa (lower right of the abdomen), which can sometimes start in the epigastrium (that is, in the upper middle of the abdomen). abdomen) to then locate in right iliac fossa, "says the surgeon. Sometimes the pains are accompanied by fever . It can also include an aggravation of pain when walking, nausea or vomiting and urges to urinate more frequently.

However, no need to panic prematurely. "The localized pains in the right iliac fossa are very frequent and the majority are not due to appendicitis, reassures Dr. Duchalais.Pains in the right iliac fossa must be consulted when they are not calmed by analgesics (drugs against pain) such as paracetamol or when they persist for more than 24 hours and are accompanied by fever. "

What treatment in case of appendicitis crisis?

Classically, the treatment of appendicitis goes through surgery . Dr. Emilie Duchalais explains: "The procedure is to cut the appendix at its base of implantation on the right colon to extract it from the belly (this is what is called" appendectomy ")." The operation always takes place under general anesthesia and most often by laparoscopy . "By laparoscopy, we make a scar at the level of the navel (about a centimeter long) through which we pass a camera.We make two other small scars (less than one centimeter) at the bottom right and above the pubis to pass instruments to cut and extract the appendix, and in the child and the thin adult it is also possible to remove the appendix by a single scar 2 cm long in the right iliac fossa. "

And that's almost everything. If appendicitis is simple (that is, uncomplicated with peritonitis), no antibiotic therapy is prescribed in addition to the operation. If peritonitis complicates appendicitis, antibiotic treatment is continued for two to five days after the operation, depending on the extent of peritonitis.

Other treatments may be proposed but the operation remains the reference treatment, as explained by Dr. Duchalais: "recently it has been proposed to treat appendicitis with antibiotic treatment alone without surgery. Antibiotic-treated patients have a 30-40% risk of surgery in the following year, either for failure of antibiotic treatment or for recurrence of appendicitis. Because of the risk of allowing appendicitis to progress to peritonitis in the event of failure of antibiotic treatment, surgical treatment remains the standard treatment. "

What are the risks of complications?

The risk of complication of appendectomy is rare. It is less than 3%. "We must remember that appendectomy is a simple and fast surgery, reassures the surgeon.The three most common complications are: the development of an abscess in the abdomen or scars of the abdomen (treatment of this complication is most often based on antibiotics, more rarely on the setting up of a drain under local anesthesia and exceptionally on a reoperation to evacuate the abscess), the return to a normal transit (resulting in intolerance to diet and vomiting during the few days following the procedure) and finally, the appearance of a hematoma on the scar (there is no specific treatment for this complication ... only pain medication ). "

The professional is reassuring: "the very media complication of the bleeding is really exceptional.The existing cases are probably counted on the fingers of the hand."