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Acute Appendicitis Symptoms – Despite the seriousness of this problem, symptoms of appendicitis usually start out fairly mild. Over time, they can become severe. Watch for symptoms such as:

Sudden pain that starts near your bellybutton and shifts to your lower right abdomen. Pain that gets worse when you take deep breaths, cough, or sneeze. Nausea. Vomiting. Constipation. Loss of appetite.

Because such symptoms can also be signs of many other gastrointestinal problems — from gas to a stomach bug to chronic conditions, including — it’s important to pay attention to your general health so you notice any changes.

When I take a deep breath my lower abdomen hurts?

Stomach pain when breathing can result from injury, a hiatal hernia, pleurisy, acid reflux, and other causes. It is often a sign of damage to the muscles or tissues in the chest cavity rather than the stomach. When a person breathes, the diaphragm tightens and relaxes as air moves in and out of the lungs.

1. The diaphragm is a large, thin muscle at the bottom of the chest.
2. Due to the position of the stomach just below the diaphragm, pain when breathing can feel as though it is in the stomach when it is actually coming from the diaphragm or other nearby chest muscles and tissues.
3. In this article, we describe some of the possible causes of stomach pain when breathing.

We also explain when to see a doctor. As with any muscle, it is possible for a person to injure their diaphragm. Causes of diaphragm injuries can include:

heavy blows to the chestinjuries that penetrate the chestsevere coughingsurgery

It can be difficult for doctors to diagnose diaphragm injuries because they often occur alongside other significant injuries to the abdomen and chest area. It is also possible that a person may not experience symptoms until weeks or even months after the injury occurred. The symptoms of a diaphragm injury can include:

pain in the abdomen or chestdifficulty breathinga coughnauseavomiting

The diaphragm needs to move continuously to support breathing, so it is not possible for an injury to recover through rest alone. People with diaphragm injuries usually require surgery to repair the damage. Gastroesophageal reflux disease ( GERD ) is a condition in which acid leaks out of the stomach and flows back up into the esophagus, or food pipe.

pain in the chest or upper abdomenbreathing difficultiesnausea or vomiting bad breath painful swallowing or difficulty swallowingtooth decay

GERD can occur when the valve at the bottom of the esophagus becomes weak or impaired. Causes of GERD and potential risk factors include :

being overweightbeing pregnantsmokingcertain medications, such as calcium channel blockers and nonsteroidal anti-inflammatory drugshiatal hernia

Some people can control the symptoms of GERD by making dietary and lifestyle changes. These can include :

maintaining a healthful weight or losing weight if necessaryavoiding wearing tight clothingstopping eating at least 2 hours before bedtimehaving several small meals a day rather than three large mealskeeping the body upright after eating quitting smoking if necessaryraising the head of the bed by 6 to 8 inches

Certain foods can also trigger or worsen symptoms in some people. Avoiding these foods may help reduce or prevent symptoms. Examples of common trigger foods include :

chocolate coffee peppermintgreasy, fatty, or spicy foodstomatoesalcohol

Doctors can also prescribe medications that help reduce stomach acid and control symptoms. For people with difficult-to-treat GERD, a doctor may recommend surgery. A hiatal hernia, or hiatus hernia, occurs when the top of the stomach pushes through a weakened section of the diaphragm. Doctors do not fully understand what causes a hiatal hernia, but risk factors include :

being over the age of 50 yearsbeing overweight or having obesity smoking

A hiatal hernia does not usually cause symptoms itself, but it can make it easier for stomach acid to flow up into the food pipe, which can lead to GERD. The most common symptoms of GERD are heartburn and acid reflux, but it can also cause breathing difficulties and pain in the chest or abdomen.

• People with a hiatal hernia who experience few or no symptoms may not require treatment.
• For people with symptoms, treatment is generally similar to that for GERD and includes lifestyle modifications and medications that reduce stomach acid.
• If these treatments are not effective, a doctor may recommend surgery.

During pregnancy, a woman’s uterus expands, which can place pressure on the diaphragm. Hormonal changes, such as increased progesterone levels, might also lead to deeper breathing. These two changes may cause shortness of breath and pain or discomfort in the chest or abdomen in some women, particularly in the third trimester.

maintaining good postureusing pillows to prop up the upper body while sleepingtaking it easy and avoiding activities that trigger or worsen symptoms, such as strenuous exercise

Pleurisy is an inflammation of the pleura, which is a thin membrane that folds back on itself to cover the lungs and line the inside of the chest cavity. This inflammation creates friction between the two layers of the membrane, which can cause sharp, stabbing chest pain when a person breathes deeply or coughs. Other symptoms of pleurisy can include :

shortness of breathunintentional weight losscoughing fever and chills

Other pleural disorders involve the buildup of gas, fluid, or blood within the pleural space, which is the area between the two layers of the membrane. These disorders can cause symptoms that are similar to those of pleurisy, together with:

rapid heart rate fatigue anxiety restlessnessrespiratory failure

People with symptoms of a pleural disorder should see a doctor as soon as possible. The treatment options will depend on the type of disorder, the underlying causes, and the severity of any symptoms. Doctors may prescribe anti-inflammatory medications to help relieve symptoms.

They may also recommend a procedure to remove fluids, gas, or blood from the pleural space. Share on Pinterest A person who is experiencing severe or ongoing abdominal pain or breathing issues should see a doctor. Pain in the stomach area or abdomen that occurs while breathing may resolve without treatment.

However, people with severe, recurring, or ongoing abdominal pain or breathing difficulties should see a doctor. Anyone who experiences the following symptoms should seek immediate medical attention:

severe breathing difficultiessharp, severe chest paindizzinessconfusionfrequent vomiting

Stomach pain when breathing is often due to a problem with the diaphragm or other muscles or tissues in the chest cavity rather than the stomach itself. Causes can include diaphragm injuries, hiatal hernia, pregnancy, GERD, and pleurisy. It is important to see a doctor for recurring, ongoing, or worsening pain when breathing.

What is this sharp pain in my lower left abdomen?

Left lower quadrant – Pain that is specifically in your lower left abdomen is most often related to diverticulosis and diverticulitis of the colon. Diverticula (small outpouchings in the bowel wall) can occur throughout your colon, but they usually develop in the lower left part.

Should I go to the ER for lower left abdominal pain?

If the abdominal pain is severe and unrelenting, your stomach is tender to the touch, or if the pain extends to your back, you should immediately visit the closest emergency department.

Can ovarian cysts cause sharp stabbing pain?

Symptoms of an ovarian cyst – An ovarian cyst usually only causes symptoms if it splits (ruptures), is very large or twists and then blocks the blood supply to the ovaries. In these cases, you may have:

pelvic pain – this can range from a dull, heavy sensation to a sudden, severe and sharp painpain during sexdifficulty emptying your bowelsa frequent need to urinate heavy periods, irregular periods or lighter periods than normalbloating and a swollen tummyfeeling very full after only eating a littledifficulty getting pregnant – although fertility is usually unaffected by ovarian cysts

See a GP if you have symptoms of an ovarian cyst. Ask for an urgent GP appointment or get help from NHS 111 if:

you have sudden, severe pelvic painyou have pain in your tummy (abdomen) and you also feel sick (nausea) or are being sick (vomiting)

You can call 111 or get help from 111 online

When I take a deep breath I have pain on my left side?

A sharp pain in the chest or ribs when breathing in may be due to a muscle strain or anxiety. But, it can sometimes indicate an injury, pneumonia, pleurisy, or pericarditis, which may need urgent medical attention. Pain around the chest and ribs will often resolve on its own or with minimal treatment.

1. However, it can occasionally be an emergency, requiring urgent medical intervention.
2. In this article, we discuss seven possible causes of sharp pain when breathing in and explain when to seek medical attention.
3. Pneumonia is an infection of the lungs that causes inflammation of the air sacs, which fill up with fluid or pus.

Pneumonia occurs as a result of bacterial, viral, or fungal infection. The severity of the condition depends on a person’s age and overall health. People with pneumonia often experience chest pain when breathing in. The other symptoms, which may range from mild to severe, include:

a cough coughing up sputum, a green or rusty phlegm, from the lungshigh feverchills difficulty breathingfatigue sweatingfast heartbeat

Both the type of pneumonia and the severity of the condition will determine the treatment options.

For bacterial pneumonia, which is the most common form, antibiotics may help treat the symptoms. Antiviral medications, rest, and a high intake of fluids may help treat pneumonia resulting from a virus. Antifungal medications may help treat fungal types of pneumonia.

A doctor may also recommend over-the-counter (OTC) medications to reduce the symptoms of pneumonia. Learn more about pneumonia here. Pneumothorax, also known as a collapsed lung, occurs when air enters the pleural cavity, which is a space between the lungs and chest wall.

The air accumulation can increase pressure in the pleural cavity, making part of a lung or even an entire lung collapse. Pneumothorax can occur as a result of a chest injury or an underlying lung disease, such as tuberculosis. People with pneumothorax may experience sharp pain in the chest that worsens during breathing or coughing.

The degree of collapse determines the signs and symptoms of pneumothorax. These may include:

shortness of breathsudden chest paintightness in the chestheart palpitationsfatigue cyanosis, which is where the skin or lips turn slightly blue

Treatment for pneumothorax involves inserting a chest tube or needle to remove excess air from the pleural cavity. For mild cases, the condition may heal without this procedure being necessary. Learn more about pneumothorax here. Pleurisy is an inflammation of the pleura, a tissue that lines the chest cavity and covers the outside surface of the lungs.

sharp pain in the chest that worsens during breathingpain that radiates to the shoulders and backshortness of breathcoughing

The treatment for pleurisy will depend on the cause of the underlying condition. For instance, if the condition is due to a bacterial infection, a doctor will prescribe antibiotics to manage the symptoms. For the pain and inflammation that pleurisy causes, a doctor will recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.

Learn more about pleurisy here. Costochondritis is an inflammation of the cartilage, a tissue that connects the breastbone and ribs. The chest pain that costochondritis causes can range from mild to severe. People with costochondritis often experience chest pain, which may radiate to the back. The exact cause of costochondritis is unclear.

However, the condition may result from a chest injury, strenuous exercise, severe coughing, or a joint infection. Costochondritis typically heals on its own. However, a doctor may prescribe NSAIDs to relieve pain. Physical therapy, including stretching exercises and nerve stimulation, may also be helpful, as may heat treatment.

• If other measures do not work, a doctor might recommend injecting corticosteroids or numbing medication directly into the affected area.
• Learn more about costochondritis here.
• A traumatic injury to the chest may result from a sports-related incident, a surgical procedure, or an accident, such as a fall from a height.

Approximately two-thirds of people who experience physical trauma have chest trauma, with the severity ranging from a rib fracture to injury of the heart. Chest trauma can lead to sharp pain when breathing in. Other symptoms of chest trauma may include:

shortness of breathpain that radiates to the neck or backcoughing up bloodbruising of the chest wall

Doctors will determine the best treatment for chest trauma based on the cause and severity. For instance, if a person is gasping for air, cardiopulmonary resuscitation (CPR) will likely be the first approach. People with chest trauma should seek immediate medical attention.

Learn more about broken ribs here. Severe stress and anxiety may cause anxiety attacks, a possible symptom of which is sharp pain when breathing in. An anxiety attack can produce a stabbing, needle-like sensation in the middle of the chest. The dread of an upcoming event or a fear that something could happen typically triggers the condition.

People may experience the following symptoms during an anxiety attack:

chest painheart palpitationsdifficulty breathinglightheadednesssweatinga headache

Treatment options for anxiety-related disorders include:

cognitive behavioral therapy (CBT) support groups for people with specific conditionsprescription antidepressants or anxiolytics to reduce the symptoms, in some cases

Anyone considering seeking professional help should ensure that they select a well-trained and qualified professional. Learn more about anxiety attacks here. Pericarditis is an inflammation of the pericardium, the sac-like tissue surrounding the heart. The cause of pericarditis remains unclear, but viral infections are a common cause. Other factors may also cause pericarditis, including:

injury to the heart or surgeryinflammatory disorders, such as rheumatoid arthritis or lupus other health conditions, including tuberculosis or kidney failure

People with pericarditis experience sharp pain when breathing in or a dull ache that may feel better when sitting upright or leaning forward. The pain may also radiate to the left shoulder and neck. Other symptoms of pericarditis can include:

fever shortness of breathlightheadednessheart palpitationsswelling of the abdomen and legsa cough

The best treatment for pericarditis depends on the cause and severity of the condition. If the condition is mild, it usually gets better on its own. For more severe cases, a doctor may prescribe OTC pain relievers and corticosteroids to reduce inflammation.

difficulty breathingchest tightness or painsevere shortness of breathrapid breathingair hunger, which refers to the inability to breathe in sufficient air sudden dizzinessfever excessive sweating

Experiencing sharp pain when breathing in can be worrying. Although the condition may not be a cause for alarm — at least in most cases — it can sometimes be a sign of a severe illness. The condition may arise due to various causes, including chest trauma and other medical conditions, such as pneumonia.

Why does it hurt when I breathe in deep on my left side?

Potential causes of lung pain include respiratory infection, pleurisy, tuberculosis, pneumonia, asthma, or pulmonary embolism. Pain in the lung area may also be related to heart or intestinal tract issues. People often cite ‘lung pain’ to describe the pain they feel in their chest.

When should I take lower abdominal pain seriously?

Stomach pain; Pain – abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly. You know that awful feeling: you’re nauseous; your stomach feels like it’s tied in a knot, and you don’t even want to move. What does your pain mean? Well, let’s talk today about abdominal pain. So, what causes abdominal pain? Almost everyone has pain in their belly at one time or another.

Most of the time, a serious medical problem is not the cause, and how bad your pain is doesn’t always reflect the seriousness of the problem causing your pain. You may feel very bad pain if you are having gas or stomach cramps due to viral gastroenteritis, better known as a stomach virus. And some life-threatening conditions, such as colon cancer or a very early case of appendicitis, may cause only mild pain, or no pain at all.

The important thing to know about abdominal pain is when you need immediate medical care. Less serious causes of abdominal pain include constipation, irritable bowel syndrome, food allergies, lactose intolerance, food poisoning, and a stomach virus. Other, more serious, causes include appendicitis, an abdominal aortic aneurysm, a bowel blockage, cancer, and gastroesophageal reflux.

1. Sometimes, you may have abdominal pain from a problem that isn’t in your belly, like a heart attack, menstrual cramps, or pneumonia.
2. So, what do you do about abdominal pain? Well, if you have mild abdominal pain, here are some helpful tips; Try sipping water or other clear fluids.
3. Avoid solid food for the first few hours.

If you’ve been vomiting, wait 6 hours and then eat small amounts of mild foods like rice, applesauce, or crackers. If your pain is high in your abdomen and occurs after meals, antacids may help, especially if you are feeling heartburn or indigestion. You should seek medical attention if you have abdominal pain and are being treated for cancer, you can’t pass any stool, you’re vomiting blood, or you have chest, neck, or shoulder pain. There are three body views (front, back, and side) that can help you to identify a specific body area. The labels show areas of the body which are identified either by anatomical or by common names. For example, the back of the knee is called the “popliteal fossa,” while the “flank” is an area on the side of the body. The process of digesting food is accomplished by many organs in the body. Food is pushed by the esophagus into the stomach. The stomach mixes the food and begins the breakdown of proteins. The stomach propels the food then into the small intestine. The small intestine further digests food and begins the absorption of nutrients. Since the abdominal area contains many different organs it is divided in smaller areas. One division method, uses one median sagittal plane and one transverse plane that passes through the umbilicus at right angles. This method divides the abdomen into four quadrants. Medical personnel can easily refer to these quadrants when describing pain or injury regarding a victim. The appendix is a small finger-shaped tube that branches off the first part of the large intestine. The appendix can become inflamed or infected causing pain in the lower right part of the abdomen. Blood from the aorta reaches the kidneys so it can be filtered and cleaned. Among other functions, the kidneys remove toxins, metabolic waste, and excess ions from the blood which leaves the body in the form of urine. You know that awful feeling: you’re nauseous; your stomach feels like it’s tied in a knot, and you don’t even want to move.

1. What does your pain mean? Well, let’s talk today about abdominal pain.
2. So, what causes abdominal pain? Almost everyone has pain in their belly at one time or another.
3. Most of the time, a serious medical problem is not the cause, and how bad your pain is doesn’t always reflect the seriousness of the problem causing your pain.

You may feel very bad pain if you are having gas or stomach cramps due to viral gastroenteritis, better known as a stomach virus. And some life-threatening conditions, such as colon cancer or a very early case of appendicitis, may cause only mild pain, or no pain at all.

The important thing to know about abdominal pain is when you need immediate medical care. Less serious causes of abdominal pain include constipation, irritable bowel syndrome, food allergies, lactose intolerance, food poisoning, and a stomach virus. Other, more serious, causes include appendicitis, an abdominal aortic aneurysm, a bowel blockage, cancer, and gastroesophageal reflux.

Sometimes, you may have abdominal pain from a problem that isn’t in your belly, like a heart attack, menstrual cramps, or pneumonia. So, what do you do about abdominal pain? Well, if you have mild abdominal pain, here are some helpful tips; Try sipping water or other clear fluids.

• Avoid solid food for the first few hours.
• If you’ve been vomiting, wait 6 hours and then eat small amounts of mild foods like rice, applesauce, or crackers.
• If your pain is high in your abdomen and occurs after meals, antacids may help, especially if you are feeling heartburn or indigestion.
• You should seek medical attention if you have abdominal pain and are being treated for cancer, you can’t pass any stool, you’re vomiting blood, or you have chest, neck, or shoulder pain.

Call your doctor if you have abdominal pain that lasts 1 week or longer, if your pain doesn’t improve in 24 to 48 hours, if bloating lasts more than 2 days, or if you have diarrhea for more than 5 days.

Can you have silent appendicitis?

K-Sign in retrocaecal appendicitis: a case series

• 1 Department of Pediatric Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
• 2 Department of General Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
• 3 Department of Accident and emergency, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

Find articles by

1. 1 Department of Pediatric Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
2. 2 Department of General Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
3. 3 Department of Accident and emergency, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
4. Corresponding author.
5. Imtiaz Wani:

Received 2009 Sep 19; Accepted 2009 Oct 19. ©2009 Wani; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

• Variations in position of the vermiform appendix considerably changes clinical findings.
• Retrocaecal appendicitis presents with slightly different clinical features from those of classical appendicitis associated with a normally sited appendix.
• Sign looks for the presence of tenderness on posterior abdominal wall in the retrocaecal and paracolic appendicitis.

This is the first case report of this kind in the literature. The K-sign has been named, as a mark of respect, after the region of origin of this sign, Kashmir, so called as “Kashmir Sign”. The sign being present in view of inflamed appendix crossing above its non palpable position above iliac crest on the posterior abdominal wall and the tenderness is by irritation of posterior peritoneum The author is reporting a case series of four patients in whom a K-sign, a clinical sign, was elicited and found positive on the posterior abdominal wall for presence of tenderness in a specific area bound by the 12 th rib superiorly, spine medially, lateral margin of posterior abdominal wall laterally and iliac crest inferiorly and was found to be present in three retrocaecal and one paracolic appendicitis.

Each case had tenderness in this specific area on posterior abdominal wall. All had appendectomy and having histopathological evidence of appendicitis. K-sign can be useful in diagnosis of retrocaecal and paracolic appendicitis. Significance of K-sign being in view of difficulty in diagnosis of retrocaecal appendicitis and its subsequent complications.

Retrocaecal appendix forms 65% of position of appendix and the retrocaecal appendicitis has several atypical presentations with a few specific signs. There is often limited systemic upset and no progression to affect the general peritoneal cavity, In the early course of the retrocaecal appendicitis, there may not be enough inflammation to cause this tenderness, although it is unusual for patients to present at early in the course of their illness.

In appendicitis other than the retrocaecal type, tenderness is due to inflammation of the serosa of the appendix and the overlying parietal peritoneum but because of its position, tenderness in right lower abdomen in retrocaecal appendicitis is not always present and may present difficulty in diagnosis.

It is to be stressed that diagnostic accuracy of appendicitis increases with a more thorough knowledge of the signs and symptoms of acute appendicitis and a constant awareness of its possible presence which gives importance of K-sign in appendicitis to a clinician.

Sign is elicited in the left lateral position by percussion of posterior abdominal wall in an area bound by spine medially,12 th rib superiorly, iliac crest inferiorly and lateral margin of posterior abdominal wall laterally, and recording an area of tenderness. Percussion is started at lateral margin of posterior abdominal wall, from 12 th rib towards iliac crest in an above to downward direction and whole area is palpated for presence of tenderness, each time starting from 12 th rib and the area of tenderness recorded.

Percussion for presence of K-sign can be also done by palpation in lateral to medial direction from lateral margin of posterior abdominal wall towards the spine and whole area is palpated, each time starting from lateral margin of posterior abdominal wall and the specific area of tenderness is noted.

• A 12 year old Kashmiri boy of Indian ethinicity presented with pain right lower abdomen and fever of 12 hours duration.
• There was history of nausea and anorexia.
• Fever of 99 degrees Farhereneit was recorded.
• Per abdominal examination revealed tenderness on deep palpation in right iliac fossa.
• Sign was found to be positive; an area of tenderness was found present in between middle of psoas muscle and an adjacent area lateral to psoas muscle extending superiorly from iliac crest.

Psoas sign was found to be positive. X-ray abdomen was unremarkable. Abdominal sonography findings being a non compressible structure in right lower quadrant suggestive of inflamed appendix. Patient had appendectomy and the 11.4 centimeters long inflamed appendix being retrocaecal in position was seen.

1. Contents in appendix was pus.
2. Post operative period and follow up being uneventful 13 year old Kashmiri boy of Indian ethinicity presented with pain right flank, fever, vomiting and anorexia of 2 days duration.
3. General physical examination revealed pulse of 96/min.
4. And fever of 99.5 degrees Fahrenheit.

Rebound tenderness and Rovsing’s sign was present on per abdominal examination. Psoas sign was negative. K-sign was elicited and was positive present in an area extending from lateral margin of psoas muscle to flank extending from iliac crest. Abdominal sonography was inconclusive.

Patient had appendectomy having 10.6 centimeters long inflamed paracoilc appendix with fecalith inside. Histopathology was consistent with appendicitis Follow up was uneventful A 9 year old Kashmiri girl of Indian ethinicity presented with epigastric pain and vomiting of 4 hours duration. She was kept under observation and after duration of 6 hours there was shift of pain to right iliac fossa and fever of 99 degrees Farhereneit was recorded.

She had pulse of 98/min and B.P of 100/70 mm. Hg. Abdominal examination revealed no tenderness in right iliac fossa. Psoas sign was found to be positive. A K-sign was found to be positive in small area on psoas muscle and adjacent posterior abdominal wall with superior extension from iliac crest.

• On X-ray abdomen there was localized ileus in right lower quadrant.
• Abdominal sonography showed a non compressible structure suggestive of inflamed appendix.
• Patient had appendectomy and an 8.4 centimeter long retrocaecal appendix was seen containing multiple fecalith inside.
• Patient was discharged on 4 th postoperative day and had uneventful follow up.

A 34 year old Kashmiri male of Indian ethnicity presented with pain right upper abdomen, vomiting and fever of 2 day’s duration. General physical revealed dehydrated look, pulse of 96/min, B.P of 120/80 mm Hg. and temperature of 100 degree Fahrenheit. Hemoglobin of 12 g./dl.

TLC of 14,000/mm 3 was present. Abdominal examination revealed tenderness in right upper and middle quadrant, the right iliac fossa was free. Psoas sign was positive. K-sign was found positive extending to 12 th rib along lateral margin of psoas muscle from the iliac crest. X-ray abdomen showed localised ileus in right upper area of abdomen.

Ultrasound abdomen was suggestive of acute appendicitis with periappendiceal collection. Patient had appendectomy and peroperative findings revealed retorcaecal, subhepatic 17.4 cm long appendix with surrounding pus present. Histopathology documented appendicitis and had uneventful postoperative as well as follow up period.

• Retrocaecal appendicitis lacks distinctive clinical pattern and has been theorized to follow a more insidious course than other anatomic variants.
• Like all other positions of the appendix, retrocaecal appendicitis can be reliably diagnosed clinically with history taking and physical examination combined with the laboratory investigations.

This retroperitoneal appendicitis is associated with a high incidence of retroperitoneal inflammatory changes which can permeate retroperitoneal fasciae and fatty tissue. For all types of appendicitis, tenderness over the site of the appendix is the sine qua non of appendicitis; patients with retrocaecal appendicitis have tenderness in the area of the appendix; provided that the area can be palpated.

1. In retrocaecal appendicitis it is difficult to found tenderness on palpation in the right iliac region.
2. Even deep pressure in the right lower quadrant may fail to elicit tenderness the reason being that the caecum, distended with gas, prevents the pressure exerted by the palpating hand from reaching the inflamed appendix, so it has been called as ‘ silent appendicitis’.

Patients with a retrocaecal appendix may experience some mild right-sided or right flank tenderness. Long retro-colic inflamed appendix may cause confusions with cholecystitis (sub hepatic). Irritation of the posterior peritoneum may occur in retrocaecal or paracolic appendicitis and give psoas sign positive.

Mc Burney’s point corresponds on right lateral line just 1.2-2.5 centimeters below the junction of intersection of right lateral plane and transtubercular plane, iliac bone along with its attachments, does not permit for eliciting tenderness at Mc Burney’s point from back. Normal length of appendix ranges from 2-20 centimeters, with an average length of 9 centimeters and consequently in retrocaecal and paracolic type it will be raised above illac crest, tenderness will be elicited in that situation on an area of contact of inflamed appendix with posterior parietal peritoneum and the area will be corresponding area of posterior abdominal wall.

Area of tenderness will depend upon length, intrinsic position of appendix, portion of appendix with inflammation, direction of appendix, presence of fibrosis, any kinking or adhesions as well as on the position of caecum. In nutshell, this sign is due to irritation by inflamed appendix of overlying posterior parietal peritoneum as in psoas sign and this sign simulates for eliciting tenderness in appendicitis in right iliac fossa.

• In our each case, appendix was long enough to cross above iliac crest and being retrocaecal and paracolic in position, sign was found to be positive.
• Further it has been rightly said that the meaning of sign in appendicits is never complete without reference to the topographical anatomy of the little organ and the situation of an acutely inflamed appendix can near always be determined by pressure method which is in support of this sign.

The significance of this sign in the retrocaecal and paracolic variety of appendix will lead to early diagnosis as these positions of appendix have the more common chances of gangrenous complication because their blood supply more prone to kinked be more liable to inflammation when fixed retro-caecally Drawback with this sign is that it cannot be elicited in obese patients since the retrocaecal appendix is so well encased in retroperitoneal fat that it cannot be easily palpated and, those having very short retrocaecal or paracolic appendix.

K-sign can be positive in other retroperitoneal pathologies like renal colic, ureteric colic and psoas abscess etc. K-sign can be useful sign in retrocaecal and paracolic appendicitis. Sometimes when meager symptoms and are signs present, this sign can be contributory in diagnosis. The author declares that he has no competing interests.

Causes of sharp pain when breathing in | The Mayfair Clinic

IW: took acquisition of data, compilation of relevant literature, formatting, revision, drafted the preliminary and final manuscript. Written informed consent was obtained from the patients or their parents for publication of this case reports. A copy of the written consents is available for review by the Editor-in-Chief of this journal

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Articles from Cases Journal are provided here courtesy of BioMed Central : K-Sign in retrocaecal appendicitis: a case series

Would it be obvious if I had appendicitis?

Signs of appendicitis – You should not ignore symptoms of appendicitis. “It’s is a very treatable condition, but left unchecked, appendicitis can lead to serious health complications, like a ruptured appendix and infection,” Dr. Hamdani says. Common symptoms of appendicitis include:

Sudden pain on the right side of the lower abdomen Sudden pain around the navel (often shifting to the lower right) Pain that worsens with movement Nausea and vomiting Loss of appetite Low-grade fever Constipation or diarrhea Bloating Gas

What triggers appendicitis?

What causes appendicitis? – Appendicitis happens when the inside of your appendix is blocked. Appendicitis may be caused by various infections such as virus, bacteria, or parasites, in your digestive tract. Or it may happen when the tube that joins your large intestine and appendix is blocked or trapped by stool.

1. Sometimes tumors can cause appendicitis.
2. The appendix then becomes sore and swollen.
3. The blood supply to the appendix stops as the swelling and soreness get worse.
4. Without enough blood flow, the appendix starts to die.
5. The appendix can burst or develop holes or tears in its walls, which allow stool, mucus, and infection to leak through and get inside the belly.

The result can be peritonitis, a serious infection.

How do I know if it’s gas or appendicitis?

Appendicitis symptoms during pregnancy – Although rare, appendicitis can also occur during pregnancy. Signs of appendicitis during pregnancy are similar to the signs of appendicitis in people who aren’t pregnant. However, the appendix sits higher in the abdomen during pregnancy because the growing baby shifts the position of the intestines.

• As a result, the sharp pain associated with an inflamed appendix may be felt higher up on the right side of your abdomen.
• A ruptured appendix can be risky for both the parent and baby.
• Pain from gas can feel like knots in your stomach.
• You may even have the sensation that gas is moving through your intestines.

Unlike appendicitis, which tends to cause pain localized on the lower right side of the abdomen, gas pain can be felt anywhere in your abdomen. You may even feel the pain up in your chest, Gas pain tends to last a few minutes to a few hours, and it usually goes away without any treatment.

If you feel relief from your abdominal symptoms after burping or passing gas, then you likely had typical gas pain. If you have gas pain that lasts for more than a few hours, it may be a sign of something more serious. Possible underlying causes include obstipation and decreased motility of the colon.

In obstipation, you can’t eliminate gas and stools, usually because of a bowel obstruction downstream. Decreased motility of the colon means that your digestive muscles don’t contract as often as they should. This can occur in some gastrointestinal conditions.

What abdominal pain makes it hard to breathe?

Abdominal bloating and shortness of breath may result from separate conditions or happen together. Occurring together, they may be a sign of obesity, a hernia, or a food intolerance, among other causes. Sometimes, abdominal bloating can affect movement of the muscles that separate the abdomen from the chest.

This can leave a person feeling short of breath. Keep reading for more information on the link between abdominal bloating and shortness of breath. This article also outlines some of the situations and conditions that can cause these symptoms to occur together. Abdominal bloating and shortness of breath can occur independently of each other.

Sometimes, however, the two symptoms may occur together. Abdominal bloating can affect the diaphragm, causing shortness of breath. The diaphragm is a sheet of muscle that separates the abdomen from the chest. The up-and-down movements of the diaphragm enable a person to breathe.

When the abdomen is bloated, however, it can press against the diaphragm, thereby inhibiting its movement. This can make breathing difficult. In other cases, conditions that affect lung capacity and breathing can cause swelling or bloating in the abdomen. Examples of such conditions include cystic fibrosis and chronic obstructive pulmonary disease (COPD),

Abdominal bloating and shortness of breath may occur together for several reasons. Some are benign, whereas others may be more serious. The following sections discuss these potential causes in more detail.