Signs of appendicitis

A typical sign of appendicitis is pain in the right lower abdomen, usually accompanied by fever, nausea, vomiting or constipation. However, the classic signs are only found in about half of those affected, especially small children and elderly people often have symptoms that differ from those of appendicitis.

Signs of appendicitis

At the beginning of a typical appendicitis, the affected persons feel a dull, not exactly localizable pain (visceral pain) in the middle or upper abdomen, often around the navel (periumbilical). Appendicitis is thus the most common cause of an acute abdomen (sudden abdominal pain). The pain moves to the right lower abdomen within the first 8-12 hours and becomes more intense over time.

There is also a change in quality to a burning, easily localised pain (somatic pain). The site of the strongest pain reaction is typically at the McBurney point. It is located halfway along an imaginary connecting line, between the right anterior iliac spine (spina iliaca anterior superior) and the navel.

In addition to the McBurney point, the Lanz point also has an increased sensitivity to pressure and knocking. The Lanz point is located between the right and middle third of an imaginary connecting line of both iliac spines. A typical sign of appendicitis is also the so-called psoas pain, which can be provoked by bending the stretched leg against resistance.

This can be explained by the anatomical proximity of the appendix and the fascia of the iliopsoas muscle (“psoas muscle”). However, if the appendix is located in the pelvis, there is an increased sensation of pain when the right leg bent at the hip is rotated (obturator sign). Furthermore, a “lose-let-pain”, also called Blumberg sign, develops in the area of the left lower abdomen, provoked by slow pressing and fast releasing in the left lower abdomen.

Which test can I do myself?

If you suffer from abdominal pain, you can do some tests to see if it could be appendicitis. However, it must be said in advance that these tests cannot replace an examination by a doctor. If you suffer from severe abdominal pain, especially in the right lower abdomen, it is essential to consult a doctor, who will carry out, among other things, an examination with several tests.

Some of these tests can also be attempted with the assistance of another person. To do this, the person affected must lie down on a hard surface as relaxed as possible. The second person presses the so-called McBurney point.

This lies in the middle of the connecting line between the navel and the right projection of the hip bone. If this test causes pain, it could be a sign of appendicitis. In the same way the Lanz point can be tested, which is located on the connecting line between the two upper protrusions of the hip bone between the right and middle third.

Another test that can indicate appendicitis in pain is the psoas sign. To do this, the person affected must lie on his back and lift his right leg against resistance (the second person holds against). However, all possible tests can only give clues.

A negative test does not rule out appendicitis and a positive test does not prove it. In addition, a lot of experience is necessary for good judgement. The overall picture and the assessment by a doctor are also decisive. Therefore, in case of doubt, the family doctor should be consulted in time or, in case of very severe pain, an emergency room should be consulted.