Appendicitis is one of the most common causes of abdominal pain, with the highest occurrence in those between the ages of 10 and 30 years. The appendix is located in the right lower quadrant just below the ileocecal valve and can be found at a midpoint between the umbilicus and right anterior iliac crest(1). Pain radiates to the part of the body supplied by somatic sensory fibers associated with the spinal segment which innervates visceral organs. This is why McBurney’s point is a typical site of tenderness(2). Inflammation can occur when the lumen between the cecum and appendix becomes obstructed or secondary to a virus, parasite, bacteria, trauma or postoperative fecal stasis(1). Diagnosis of appendicitis is important in order to avoid serious infections such as an intra-abdominal abscess as well as infertility in women secondary to ruptured appendix(3).
Patients with acute appendicitis will typically present with tenderness at the site over the appendix, McBurney’s point. Initially, pain might be subtle but becomes intense enough to interrupt sleep. Migration of pain from the epigastric area to the right lower quadrant accompanied by nausea, vomiting, anorexia and feelings of constipation are typical symptoms. Other signs include guarding of the abdominal muscles in anticipation of the physical exam, rigidity, rebound tenderness, positive psoas test, and a rectal examination that causes pain in the lower left abdomen(1).