Symptoms of Acute Appendicitis | Acute Appendicitis Diagnosis

Symptoms of Acute Appendicitis

Acute appendicitis pain

  • Pain is present in all patients with appendicitis. The initial typical pain is diffuse and dull and is situated in the umbilical or lower epigastria region.
  • Sometimes the pain is moderately severe. Intermittent cramping may superimpose on such pain. Gradually the pain is localized in the right lower quadrant.
  • It takes about 1 to 12 hours for such localization. In some patients the pain of appendicitis begins on the right lower quadrant and remains there.

Appendicitis Abdominal Pain

  • Variation in the anatomical position of the appendix will account for variation of the principal site of pain.
  • In case of appendix situated behind the caecum, pain may be complained of more in the flank.
  • In case of pelvic appendicitis, pain may be referred to the supra-pubic region. Mal-rotation of the appendix will lead to more confusion of the site of pain.

Appendicitis Anorexia

  • Nearly always anorexia is complained of in case of appendicitis. This symptom is constant and helps in forming the diagnosis of appendicitis.

Appendicitis Nausea

  • Nausea at least of some degree, is present 9 out of 10 patients with appendicitis.
  • Vomiting is variable. Children and teenagers frequently vomit but vomiting may be entirely absent in adult.
    Most patients vomit only once or twice. Vomiting is usually not persistent. Vomiting appears after the onset of pain.
  • Typically pain, vomiting and temperature constitute Murphy’s triad of this condition. If vomiting precedes pain the diagnosis should be questioned.

Bowel function

  • Character of bowel function is of little diagnostic value. Many patients give history of constipation before the onset of abdominal pain. A few voluntarily submit that defecation relieves their pain.
  • To the contrary diarrhea occurs in some patients, particularly in children.

Acute Appendicitis Diagnosis

  • The sequence of symptom appearance has great diagnostic value. In over 95% of patients anorexia is the first symptom, followed by abdominal pain and this is followed by nausea and vomiting.


  • Rise in temperature may be caused by appendicitis, but with uncomplicated appendicitis higher temperature is unusual. Elevation of temperature is restricted to about 100 degree Fahrenheit.
  • Pulse rate may be normal or in some cases slightly higher.