Suppurative Appendicitis

What is suppurative appendicitis?

Suppurative appendicitis may be a later stage of appendicitis or it may be a different condition completely. There are still many unknowns about suppurative appendicitis, although it is a fact that treatment is always surgical and your prognosis is generally good.

Suppurative appendicitis has long been considered an advanced stage of appendicitis. It occurs when inflammatory fluids and bacteria which have accumulated in your appendix's lumen enter its wall of structure, causing intense pain as the inflamed membrane makes contact and rubs against the abdominal cavity's parietal peritoneum lining.

In its most simple form, suppurative literally means ‘forming pus' and in the case of suppurative appendicitis, liquefactive necrosis, which are essentially pockets of pus, form on the appendix wall's mucosa.

Extreme pain in your abdomen is the main symptom and an appendectomy is the treatment required. The pain you experience is likely to last for longer than with acute appendicitis and the condition may take longer to diagnose.

Suppurative appendicitis has traditionally been seen as an indicator of medical care, as a delay in either diagnosis or treatment are believed to increase the risk of suppuration, although some newer research suggests that there may be other factors and that time and human indecision or inactivity may play no part at all.

One study, for example, suggests that suppurative appendicitis is often caused by an obstruction of a person's appendix rather than what is known as mucosal ulceration (thought to be a more common cause of acute appendicitis).

Causes of appendicitis

It is not known exactly what causes appendicitis but it is thought that most cases result from something blocking the appendix's entrance, such as some feces. An upper respiratory tract infection may also cause a lymph node in the bowel wall to swell. This obstruction results in inflammation and the pressure caused by this swelling can make your appendix burst.

Appendicitis in general

Central to the condition known as suppurative appendicitis is the general illness, appendicitis. This is the term given when your appendix becomes inflamed.

The appendix is a thin pouch, measuring around two to four inches long, which connects to the large intestine. The appendix has no known purpose and it can be safely removed.

Symptoms of appendicitis

Appendicitis usually starts with a central stomach pain which can come and go. In a matter of hours, the pain will travel over to the lower right of the stomach. This is where the appendix is usually found. The pain will also become severe and constant. Pressing down on the area, walking or coughing can make your pain worse and you may feel sick, have diarrhea and lose your appetite.

Atypical appendicitis, such as suppurative appendicitis, can be harder to diagnose than other types of appendicitis and is often more complicated to treat, even if you are operated on early. Even if you have suppurative appendicitis, however, your prognosis is still excellent. Deaths from a perforated appendix are very rare and even in elderly patients and infants, mortality is still below five percent.

Treatment for appendicitis

If you have appendicitis of any type you will normally have to have your appendix surgically removed and this is always the case with suppurative appendicitis.

The procedure to remove your appendix is called an appendectomy or appendicectomy and it usually involved keyhole surgery, known as a laparoscopy. Open surgery is normally only used if the surgeon cannot get access to your appendix or if it has burst.

This is a very common procedure and, whilst all general anesthetics carry some degree of risk, risks are extremely low. Most people will fully recover within two weeks of having the surgery, although you might need to avoid strenuous activity for six weeks if you have to have open surgery.

Once you are fully recovered from the operation, you will be able to return to the lifestyle you had before. There are no changes you need to make to your diet or exercise regime, for example, unless there are other reasons to make alterations.

Differences between acute and suppurative appendicitis

Some researchers believe that suppurative and acute appendicitis are different disease processes altogether. One study by Andersson et al seemed to support this theory by finding that acute appendicitis was most likely to occur during puberty, while there was no particular age associated with higher occurrences of suppurative appendicitis.

Last Reviewed:
August 15, 2017
Last Updated:
October 24, 2017
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