Appendicular abscess history and symptoms

Obtaining the history is an important aspect in diagnosing appendicular abscess, which may provide insight into causes, precipitating factors, and associated conditions. A complete history will help determine the correct therapy. Asking specific questions about symptoms and health history will help rule out other conditions. The onset, location, severity of pain and knowing when other symptoms appeared relative to the pain is helpful. Symptoms of appendicular abscess are mostly atypical compared to appendicitis and include high-grade fever, constant pain in the right iliac fossa, prolonged diarrhea associated with nausea and vomiting and increased micturition and tenesmus.

The key to an efficient and accurate diagnosis is a detailed and thorough history. The following information should be obtained:^[1]

• Onset, location, radiation, and duration of pain
• Aggravating or relieving factors
• Severity of pain (constant or intermittent)
• Characteristics of the pain
• History of the pain
• Association with nausea, vomiting, anorexia, or diarrhea
• Time of last bowel movement
• Recent use of analgesics, narcotics, or antibiotics

Symptoms of an appendicular abscess include that of appendicitis with late presentation and can overlap. Typical symptoms of appendicitis may or may not be present but patient presents with:

• Fever >38.5 C
• Generalized abdominal pain
• Vomiting
• Prolonged diarrhea
• Increased micturition due to irritation of the bladder wall by the inflamed appendix
• Tenesmus