chronic appendicitis Chronic appendicitis refers to the occurrence of chronic inflammation in the appendix, which persists and is mainly manifested as recurrent right lower abdominal pain. Its main pathological feature is the presence of a large number of chronic inflammatory cells (lymphocytes and eosinophils) infiltrating the appendix.

Chronic appendicitis refers to the occurrence of chronic inflammation in the appendix, which is prolonged and does not heal, mainly manifested as recurrent right lower abdominal pain. The main pathological feature is the presence of a large number of chronic inflammatory cells (lymphocytes and eosinophils) infiltrating the appendix.

Secondary chronic appendicitis

Mostly due to successful conservative treatment of acute appendicitis, leading to deformation and stenosis of the appendix lumen, or prolonged retention of small fecal stones, resulting in the development of chronic appendicitis.

Primary chronic appendicitis

This type is less common. Some patients may have a long history of symptoms during acute appendicitis, lasting for several months or even years, with intermittent symptoms of right lower abdominal pain.

Appendiceal lumen obstruction

The main cause of chronic appendicitis is obstruction of the appendiceal lumen. After the obstruction, the mucosa of the appendix becomes ischemic, leading to excessive bacterial proliferation and increased susceptibility to infection.

Invasion of bacteria

After obstruction of the appendiceal lumen, bacteria from the colon shift into the appendix, leading to bacterial proliferation and appendicitis.

Most patients have a history of previous acute appendicitis, and the symptoms of chronic appendicitis mainly manifest as right lower abdominal pain. The pain is recurrent and prolonged, lasting for several months or even years. Some patients may have no history of acute appendicitis and only experience intermittent discomfort or pain in the right lower abdomen.

During palpation of the right lower abdomen (appendix area), there may be mild to moderate tenderness, with a localized and relatively fixed position. In the left lateral position, a doctor may feel a cord-like mass in the right lower abdomen.

Unless accompanied by a recurrent acute attack, patients with chronic appendicitis usually do not experience systemic symptoms such as nausea, vomiting, fever, or fatigue.

During an acute episode of chronic appendicitis, prompt medical attention should be sought, and the doctor will manage it in a similar manner to acute appendicitis.

For recurrent or multiple acute episodes of chronic appendicitis, surgical treatment is recommended as a priority.

After appendectomy, the following points should be noted in the early stage:

Early ambulation

Currently, laparoscopic appendectomy is the preferred surgical method for appendicitis, with minimal trauma and rapid recovery. Patients can usually start ambulation on the second day after surgery. Early ambulation can promote gastrointestinal function recovery and reduce the occurrence of complications. To alleviate incisional pain, an abdominal binder can be worn, especially during coughing or physical activity, and analgesic drugs may be used if necessary.

Gradual increase in exercise

After surgery, patients should start with short-distance walking, and gradually resume normal activities after one week.

Pay attention to diet hygiene and avoid indigestible foods.

Develop regular bowel habits to prevent the formation of fecal stones that can obstruct the appendix lumen.

Undergo regular physical examinations and receive timely treatment for diseases that can cause appendix obstruction.

In cases of non-surgical treatment for acute appendicitis, a sufficiently long treatment period should be implemented to reduce the likelihood of it developing into chronic appendicitis and recurring episodes.

For patients already diagnosed with chronic appendicitis, they should avoid strenuous activity or irregular diet to reduce the likelihood of triggering acute appendicitis.