Appendicular Abscess : Causes, Symptoms, Treatment & More

Overview

An appendicular abscess is a complication of acute appendicitis, which is an inflammation of the appendix. The appendix is a small, finger-shaped pouch that protrudes from your colon (a tube-like connecting organ between the small intestine at one end and the anus at the other) on the lower right side of your abdomen. 

Appendicitis causes sudden and severe pain in the lower right side of your abdomen. If appendicitis is accompanied by infection, it could lead to life-threatening complications like an appendicular abscess. This article discusses appendicular abscess, their causes, symptoms, complications, and treatment.

What Is An Appendicular Abscess?

An abscess is a collection of pus and dead and decayed tissue within a confined area around a burst appendix. If left untreated, acute (arise suddenly), appendicitis may burst due to intense pressure within the tissues, leading to life-threatening complications like an appendicular abscess, an extremely painful condition that needs immediate treatment. 

What Causes An Appendicular Abscess?

An appendicular abscess commonly occurs due to aerobic (an organism that requires oxygen for its growth and survival) and anaerobic (an organism that does not require oxygen for its survival and dies due to the presence of oxygen) bacteria. These are natural habitats of your gut, but when they multiply rapidly, they can inflame your appendix, which, when ruptured, may lead to an appendicular abscess. Other possible causes include:

• Appendix stones that are calcified deposits in the appendix
• An abdominal injury
• Benign (non-cancerous) and malignant (cancerous) tumors

Furthermore, certain risk factors could increase your likelihood of developing an appendicular abscess like:

• Being a teenager or in your 20s and early 30s 
• Uncontrolled diabetes ( increased blood sugar levels) 
• Men with a condition called cystic fibrosis (a life-threatening genetic disease that damages lungs and digestive system)
• If you have a family history of appendicitis

What Are The Symptoms That You Need To Look Out For?

Symptoms of an appendicular abscess include appendicitis which presents with:

• Fever of >38.5?(>101.3?)
• Generalized abdominal pain and cramps, especially towards your lower right side.
• Nausea and vomiting
• Chronic (long-lasting) diarrhea
• Increased micturition (a condition where urine is expelled from the body) due to the increased irritation of the bladder wall by the inflamed appendix
• Tenesmus, which is a feeling that you need to pass stools even after your bowels are empty.

How Is An Appendicular Abscess Diagnosed?

When you observe any of the above symptoms, consult your healthcare provider for further evaluation and diagnosis.  Your doctor will conduct the following assessment and diagnostic tests:

Physical examination

• Your doctor will examine your abdominal area and exert mild pressure to check for pain and tenderness.

Laboratory findings

• These include blood tests with abnormal platelet count, abnormal liver function, and anemia (a condition where the blood does not have enough healthy RBCs). 
• Blood cultures help identify the bacteria responsible for the formation of abscesses.

Other confirmatory tests include

• Ultrasound scan
• Abdominal CT (Computed Tomography)
• MRI (Magnetic Resonance Imaging)

What are the Treatment Measures for an Appendicular Abscess?

Once your doctor has effectively diagnosed an appendicular abscess, the treatment approaches followed are:

Non-surgical

This is the first line of treatment that includes medications and drainage. 

Medications

• Antibiotics are the preferred choice of medications once the bacteria causing the abscess is identified through a blood culture test.
• Your doctor may prescribe IV (intravenous) antibiotics for 5 to 7 days.
• IV  route is preferred to oral since it is fast acting and provides relief from symptoms like fever and pain quickly.

Incision and drainage 

• This is an in-patient procedure (requires hospitalization) and performed under spinal or general anesthesia (sedative).
• An ultrasound or CT scan can guide the radiologist to perform drainage of the abscess.
• A small tube is placed into the abscess to drain the infection.
• You will be given IV antibiotics during your hospital stay.
• Once you no longer have a fever and pain and can tolerate a regular diet, you will be sent home.
• After 6 to 8 weeks, you have to return to the hospital for the surgical removal of your appendix to prevent the recurrence of appendicitis.

Surgical

After antibiotics and drainage of the abscess, surgical intervention (appendectomy) is required. This is done after 6 to 8 weeks to prevent the recurrence of appendicitis.  

Open appendectomy

• Performed under general anesthesia.
• It involves a large incision near the location of your appendix.
• The appendix is removed, and the wound is closed with sutures (stitches).
• Recovery takes around 4 to 6 weeks.

Laparoscopic appendectomy

• This is a minimally invasive (there is less trauma, pain and bleeding) procedure done under general anesthesia.
• Small 2 to 3 keyhole-sized cuts (incisions) are made according to the location of the appendix.
• A special device called a laparoscope is used and inserted through one of the keyhole-sized cuts.
• A laparoscope is a device that consists of a tiny camera at the end and a light source. The images are taken from inside the surgical site and projected on a large screen. The surgeon can perform the procedure through these images.
• The wounds are tiny and require small stitches, and a surgical dressing is placed over them.
• Recovery is quick and takes only around 3 to 4 weeks.

Are There any Complications Associated with an Appendicular Abscess?

An appendicular abscess is a life-threatening complication of acute appendicitis, hence it should be treated accordingly. If left untreated, an appendicular abscess may lead to complications like:

• Septicemia- The bacteria from the abscess can dislodge into the bloodstream and travel to other parts of your body resulting in a condition called septicemia. The symptoms include chills, fever, rapid heart rate, etc.
• Rupture- If left untreated, the abscess can cause increased tissue pressure, leading to rupture. This can be localized (to one part) or generalized (spread to other parts of the body). 
• Peritonitis- If the abscess bursts, it may cause the bacteria to spread to the peritoneum (a thin layer of tissue that lines the inside of the abdomen).
• Tissue death- Also known as gangrene, which is caused due to increased necrosis of the surrounding tissues to the extent that it is deprived of normal blood flow.

How to Prevent an Appendicular Abscess?

There are no proven preventive measures to prevent an appendicular abscess. Since appendicular abscess is a common complication of appendicitis, preventing appendicitis will, in turn, prevent abscess formation. 

• Consume a high-fiber diet that includes fresh fruits and vegetables and whole grains. 
• Avoid junk, fried, and processed foods.
• Avoid alcohol, sugary fruits, and red meat.
• Hydrate yourself well by drinking at least 6 to 8 glasses daily.

An appendicular abscess is a life-threatening complication of appendicitis that should be treated accordingly. Antibiotics, drainage, and appendectomy aid in treating the abscess, which, left untreated, can cause complications like peritonitis and septicemia, which are medical emergencies.

If you experience severe abdominal pain, consult our expert healthcare professionals at Medfin for further evaluation and treatment. We are well-equipped in laparoscopic appendectomy and ensure good surgical outcomes with quick recovery.

Why choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!