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Chronic appendicitis is a rare condition that involves long-term swelling of the appendix, which is a small piece of tissue at the bottom of the large intestine. Acute appendicitis usually produces severe symptoms, and immediate surgery to remove the appendix is typically necessary. The chronic form of the illness may not require surgery, though some doctors elect to remove the appendix in cases of chronic appendicitis because the appendix is not needed for any major bodily function. Appendicitis can cause the appendix to swell to the point of bursting, which empties liquids into the abdomen that can lead to a serious infection.
Symptoms of chronic appendicitis are very similar to the symptoms of acute appendicitis, but they typically last longer and are not as severe. Abdominal pain is the most common symptom, and it usually starts around the navel area and radiates to the right side of the abdomen. The pain is often worse when lifting heavy objects or making sudden movements. Tenderness to touch is another common symptom, and chronic appendicitis patients may also experience minor nausea and abdominal swelling.
The symptoms of appendicitis are the same as other abdominal problems and ailments, so doctors often need to perform several tests to diagnose the condition. If acute, severe appendicitis is ruled out and a doctor usually performs a manual examination of the abdomen to check for swelling and tenderness near the appendix. In some cases, imaging studies, such as ultrasounds, are needed to detect inflammation. Blood and urine tests may be ordered to detect underlying infections that may be responsible for chronic inflammation of the appendix.
In some cases, chronic appendicitis can be treated with antibiotics that relieve the swelling and infection. Many patients diagnosed with the condition may need antibiotics on a regular basis, but the swelling often comes back. Patients who are otherwise healthy and able to undergo surgery without any major risks, such as allergic reactions to anesthesia or abnormally heavy bleeding, may have their appendixes removed to prevent the condition from recurring.
During an appendectomy, a surgeon makes a long incision in the abdomen or several small incisions to enter the abdomen with a laparoscope, a small instrument with a light and camera on the end. Laparoscopic surgery allows the patient to heal quicker and is often suitable for patients with chronic appendicitis because the appendix hasn't ruptured. Once the appendix has been removed, the patient must rest for several days and avoid strenuous activities that could cause the incision to split open.