Appendicitis is an inflammation or infection of the appendix, the finger-shaped organ attached to the colon and located in the lower right portion of the abdomen. Problems with the appendix require immediate medical attention; inflammation and infection can cause the appendix to burst and infect other parts of the body.
The appendix was long thought to have no purpose, but recent studies have shown that it may act as a safe house for good bacteria that help the body recover after a serious illness. Still, the appendix does not have an essential daily role in the body, and this makes diagnosis more difficult for doctors.
When doctors fail to diagnose appendicitis, serious conditions like peritonitis, or inflammation of the inner wall of the abdomen, can result. Appendicitis symptoms are similar to those of many other conditions, and it is commonly misdiagnosed. Misdiagnosis rates for appendicitis are about 9% for men and 23% for women. Men are often misdiagnosed with intestinal tract and colon infections, and women are often misdiagnosed with conditions of the ovary or uterus.
If the small opening in the appendix becomes blocked as a result of - inflammation or infection, the appendix can burst, releasing bacteria into the abdomen. Free intestinal bacteria in the abdominal cavity cause infections known as peritonitis. Appendicitis is the leading cause of emergency abdominal operations in the United States. Without timely surgery and antibiotics, the mortality rate from appendicitis is about 50%. With treatment, the mortality rate is less than 1%. The National Institute of Health (NIH) estimates that about 400 people die each year in the United States from appendicitis.
Annually, there are about 300,000 cases of appendicitis in the United States. It is most common in children and teenagers.
Risk Factors and Symptoms
There are almost no risk factors for appendicitis, and it has no connection to lifestyle factors. The only risks factors are a family history of appendicitis and having cystic fibrosis.
The most common symptom of appendicitis is a pain on the right side of the abdomen. Other symptoms include:
- Low-grade fever
- Abdominal swelling
- Loss of appetite
These symptoms are common to many other conditions, and not all of these symptoms will be present in every appendicitis case. This makes diagnosis difficult for doctors.
To diagnose, appendicitis doctors need to perform a variety of tests to both determine if the appendix is infected or blocked and to rule out other medical conditions that could be causing symptoms. Currently, about 1 in 5 appendicitis cases are misdiagnosed as other conditions.
The first step in diagnosing appendicitis is a physical examination. Doctors may examine the abdomen for signs if inflammation, such as pain and tenderness, particularly on the right side. A rectal examination may also be performed.
Doctors may also order blood tests to check if the white blood count is elevated. A urine analysis may be ordered to rule out the possibility of a urinary tract infection. Imagining studies like CT scans, ultrasounds, or x-rays are used to confirm the diagnosis.
Currently, surgery is the primary treatment for appendicitis. In a procedure called "appendectomy," a doctor will make a 2-4 inch incision or will make several very small incisions to remove the appendix. If the appendix has ruptured, the doctor will clean/wash the inside of the abdominal cavity to minimize the risk of infection.
Recent medical studies show that up to 80% of appendicitis cases could be treated with antibiotics, allowing patients to avoid surgery and to keep their appendix. Antibiotics alone can be used if the patient is not at risk for appendix rupture. Doctors should be able to detect the state of the appendix with the help of imaging studies. One study found that 27% of patients treated with antibiotics still needed an appendectomy within one year.
Malpractice and Appendicitis
Appendicitis is very treatable if detected, diagnosed, and managed timely. If doctors fail to timely diagnose and treat appendicitis, patients may face serious consequences, including further injuries and death.
Currently, patients in the United States face appendicitis misdiagnosis rates up to 23%. Children face misdiagnosis rates of 25-30%, with the youngest groups facing the highest rates of mortality from misdiagnoses.
Common misdiagnoses of appendicitis include:
- Crohn's Disease
- Inflammatory Bowel Disease
- Ectopic pregnancy
- Ovarian cysts
- Pelvic Inflammatory Disease
- Urinary Tract Disease
- Abdominal abscess
Patients also face the possibility of negative appendectomies, when an appendectomy reveals a healthy appendix. Medical professionals agree that some negative appendectomies are expected and acceptable to avoid the possibility of missing an actual appendicitis diagnosis. Still, patients with negative appendectomies incur significant medical expenses with longer hospital stays and related medical treatment.
If your appendicitis has been mishandled by a healthcare provider, call our offices today for a free consultation and learn more about your legal options.