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The appendix is a closed-ended, narrow tube up to several inches in length that attached to the cecum like a worm. The inner lining of the appendix produces a small amount of mucus that flows through the open center of the appendix and into the cecum. The wall of the appendix contains lymphatic tissue that is part of the immune system for making antibodies. Like the rest of the colon, the wall of the appendix also contains a layer of muscle, but the muscle is poorly developed.

Appendicitis means inflammation of the appendix. It is thought that appendicitis begins when the opening from the appendix into the cecum becomes blocked. The blockage may be due to build up of thick mucus within the appendix or to stool that enters the appendix from the cecum. The mucus or stool hardens, become rock-like, and blocks the opening. This rock is called a fecalith. At other times, the lymphatic tissue in the appendix may swell and block the appendix. After the blockage occurs, bacteria which normally are found within the appendix begin to invade the wall of the appendix.

The main symptom of appendicitis is abdominal pain. The pain is at first diffuse and poorly localized, that is, not confined to one spot. The pain is so difficult to pinpoint that when asked to point to the area of the pain, most people indicate the location of the pain with a circular motion of their hand around the central part of their abdomen. A second, common, early symptom of appendicitis is loss of appetite which may progress to nauseas and even vomiting. Nauseas and vomiting also may occur later due to intestinal obstruction.

The diagnosis of appendicitis begins with a thorough history ad physical examination. Patients often have an elevated temperature, and there usually will be moderate to severe tendernes in the right lower abdomen when the doctor pushess there. If inflammation has spread to the peritoneum, there is frequently rebound tenderness. Rebound tenderness is pain that is worse when the doctor quickly releases his hand after gently pressing on the abdomen over the area of tenderness.