Appendicitis is an acute inflammation of the appendix. Classic symptoms follow a predictable pattern:
- Periumbilical pain that migrates
Dull cramps begin around the navel; within 6–12 h the pain shifts to the right lower quadrant (McBurney point) and becomes steady and sharper . - Loss of appetite
Nearly every patient stops wanting food; this often precedes other complaints . - Nausea and vomiting
One or two episodes of nausea or vomiting typically appear after the onset of pain (not before) . - Low-grade fever
37.5–38 °C is common; temperature > 38.5 °C may signal perforation . - Rebound tenderness and guarding
Pressing on the right lower quadrant hurts less than the sudden pain that occurs when the hand is released; voluntary muscle guarding is usually present . - Bowel and urinary changes
Mild constipation or loose stools, abdominal bloating, and occasional frequent urination due to adjacent irritation are reported . - Worsening with movement
Coughing, deep breathing, or hopping intensifies the pain and helps distinguish appendicitis from other causes .
Symptoms vary in pregnancy, elderly, or children, but progressive right-sided pain with anorexia and low-grade fever remains the hallmark. Immediate evaluation is essential to prevent rupture and peritonitis.
| Symptom | Classic Pattern | Clinical Pearl |
|---|---|---|
| Pain | Periumbilical → RLQ, steady | Worsens with cough/hop |
| Appetite | Lost early | Present in 90 % |
| GI | Nausea after pain, 1–2 vomits | Vomiting first suggests gastroenteritis |
| Fever | 37.5–38 °C | > 38.5 °C → possible perforation |
| Signs | RLQ rebound, guarding | Rovsing, psoas, obturator signs support |
| Bowel | Mild constipation or loose stools | Diarrhea in pelvic appendix |
| Urine | Frequency/dysuria if bladder irritation | UA often sterile pyuria |