What are the symptoms of inflammation of appendicitis?

Diagnostics

The diagnosis of appendicitis is made as part of the medical examination. Most important to the history, the laboratory tests (WBC, CRP), and the ultrasound examination technical difficulties the CT. There is no evidence that appendicitis is present. However, a typical finding in the ultrasound diagnosis is now safe because the resolution ultrasound has greatly improved in recent years.
The exclusion of appendicitis at überblähtem intestine or in obese patients is often difficult. CT can also be helpful, especially if the patient is very thick or overinflated intestine and whose belly is using ultrasound and palpation so poorly assessed.
The previously common differential temperature measurement armpit-rectum (0.5-1 K) is now carried out any more.

Clinical examination and laboratory

The diagnosis of appendicitis is confirmed by clinical findings:
    Survey of history and physical examination of the patient with abdominal palpation of the
        The palpation of the lower abdomen McBurney point, lance-point, retrograde Darmausstreichen toward appendix (called Rovsing characters)
        Contralateral rebound tenderness (Blumberg's sign): This is (contralateral, to the left) on the opposite side of the body applied manual pressure on the lower abdomen and suddenly released. In the positive (= true) case arises then right a pain.
        Psoas stretching pain (the leg is flexed at the hip against resistance when doing abdominal pain occur, the test is positive)
        Douglas pain (pain at digital rectal examination)
    Temperature measurement
    Blood tests, urine tests may also
        Laboratory examination of the blood (leukocytosis, increased CRP, etc.)
    women always gynecological examination

In the history of the displacement of the central upper abdominal pain in the right lower abdomen, and the cessation of the beginning is periumbilical or epigastric (stomach-related) pain (belly button close) possible. The reason for this characteristic pain hike lies in the local integration of the adjacent parietal peritoneum inflammation in the disease process (visceral pain → Peritonealschmerz).

The sudden appearance of a pain-free interval followed by massive pain throughout the abdomen speaks for a breakthrough (a perforation) of appendicitis.

Imaging

- Ultrasound examination of the abdominal cavity (Kokardenformation, tubular structure, abscess, excluding other diseases): As spezifischtes sign of appendicitis is a maximum outer diameter of the appendix of greater than 6 mm or 7 mm, with a larger diameter is more specific. The inflamed appendix is at least partially around the transverse cross section and not compressible. A Appendicolith is also specific to appendicitis, regardless of the maximum outer diameter of the appendix. Secondary signs of appendicitis have a wall thickness of more than 3 mm, a halo due to edema and increased edematous mesenterisches fat.
   - Computed tomography (CT)
   - X-ray of the abdomen may standing
 differential Diagnosis
 The list of other possible diagnoses that can be hidden behind a suspected appendicitis (differential diagnosis) is long. It covers all diseases that are characterized by severe abdominal - express and abdominal pain. The medical term for this complex is "acute abdomen". Through technical examination possibilities and clinical outcome studies, these options usually require only a few diseases.