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The doctor would suspect appendicitis based on the symptom details and physical examination findings. In this article, you will get to know about procedure of Appendicitis diagnosis, appendicitis blood test results and all about other appendicitis criteria.
1. Symptom details and medical history
2. Lab tests
3. Imaging tests:
The doctor would ask several questions to characterize the pain and possible cause.
• When and how the pain has started and progressed: if it has a sudden/ gradual onset. For how long it has bee there now.
• Is abdominal pain diffuse or localized
• Where is the pain located in abdomen: like upper part, just below the rib cage, center or on sides, near the belly button or right lower side of the abdomen, etc.
• Has the pain shifted from area around the belly button to right lower side of the abdomen.
• What is the severity of pain: mild, moderate, severe or unbearable, etc.
• Are there any other symptoms associated with pain like nausea, vomiting, fever, burning in urine, etc.
• Other medical conditions: similar pain prior, any diagnosis made previously, any surgery done in the past.
• Any intake of medicine, alcohol, or drugs.
Physical examination: the doctor would look and touch the abdomen to observe some changes in the severity of pain, tightness of the abdomen muscles. The doctor might do some other tests like psoas sign, obturator sign, digital rectal examination, or pelvic examination depending on the suspicion.
Doctors also do some lab tests to aid their preliminary appendicitis diagnosis and to rule out other conditions.
Blood tests: includes CBC (complete blood count). DLC (differential leukocyte count), CRP, etc. These are done to look for evidence of infection and all about appendicitis blood test results. It may also indicate fluid and electrolyte imbalance in the body.
Pregnancy test: this may be done in women especially if there is a history of delayed or missing periods.
Ultrasound: is usually the first imaging test done to confirm appendicitis or to rule out causes that may mimic the pain of appendicitis like kidney/ureteric stone, female pelvic conditions like bleeding in the cyst of ovary, etc.
This may also detect complications of appendicitis.
The diagnosis of appendicitis may not be always be confirmed on ultrasound in some cases. The ultrasound detection of appendicitis depends on two things:
• Position of the appendix which may vary from person to person
• Amount of body fat and abdominal gases which may obliterate its viewing on ultrasound.
CT scan: uses X-rays to produce images of internal organs of the body. CT scan has a very high rate of detection of appendicitis and its complications. It is also a very good test to rule out other conditions that may mimic appendicitis diagnosis.
Precaution: women of childbearing age should aware of their pregnancy status as X-rays from CT scan can cause damage to the developing fetus. This becomes more important in a woman with a history of missed or delayed periods who should undergo a pregnancy test before a CT scan.
MRI: is generally used when CT couldn’t be performed due to
• damaging effect of X-rays to the fetus in pregnant females
• When there is contraindication against contrast used in CT.
MRI is considered safe and reliable but is costly, time-consuming, and not available in small centers in appendicitis diagnosis.
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