Appendicitis    （ in English and Chinese 中英文)

 by: Joe Hing Kwok Chu

Diagnosis

Clinical diagnosis:

Digital rectal exam

Pelvic exam to evaluate the size and position of the vagina, cervix, uterus, fallopian tubes, and ovaries; also to help detect certain cancers in their early stages, infections, including sexually transmitted diseases or other reproductive system problems.

Body temperature

Pressure application

a. knee

b. left quadrant

c. right quadrant

d. appendix location

Laboratory tests

WBC to see if white blood cell count is elevated, a sign of infection. Normal range of while cells for adults is: 4.5~11.0 X 10³/µL (SI units: 4.5~11 X10⁹/L)

Urine test to exclude urinary infection or stones, which may also cause pain.

Imaging tests

X-ray to rule out other causes of pain Ultra sound to check the size of the appendix which is  6 mm (0.24 in.) or less in diameter in a normal appendix; but the appendix cannot always be seen with an ultrasound.

CAT SCAN (CT) may be used when a diagnosis of appendicitis is uncertain. CT can be more accurate than ultrasound in diagnosing appendicitis.

When the infection of the appendix is serious, there is a chance of it bursting and causing infection of the abdomenal area which is a more serious condition.

CAT ,Computer Axial Tomography, is a series of X-rays that show the human body in slices. Computer programs are being used to turn the tomograms into pictures.

Chinese herb therapy

According to Jin Gui Yao Lue:

In chang yong (carbuncle of intestine, appendicitis), the skin is dry and cracked, the skin of the abdomen is tight. It feels soft when pressed, and  swollen, with no lump inside, no fever, rapid pulse. This means pus is formed. Use yi yi fu zi bai jiang san.

In zhong yong (swollen carbuncle), there is a lump in the lower abdomen. When pressed it is painful as in gonorrhea, but urination is normal, frequent fever, sweating, chills, slow tight pulse. It means the pus is not formed and a laxative can be used. If the pulse is large and rapid, the pus has formed, and a laxative should not be used. Use da huang mu dan tang.

《 金櫃要略》：