DR HQ: Anatomy 101—Appendicitis

Is appendicitis a baseball injury? The answer is no, but it is a common malady in the general population that surfaces a few times each baseball season. 

Health.com explains the appendicitis in the following way:

“Appendicitis occurs when the appendix—a finger-shaped organ connected to the end of the large intestine—becomes infected. Symptoms of appendicitis include abdominal pain, often starting near the belly button. The pain may move down to the lower right side of the abdomen. Appendicitis is the leading cause of emergency abdominal surgery (appendix surgery is called an appendectomy) and is most likely to strike people between the ages of 10 and 30—although it can occur at any age.”

That pretty much sums it up, but this ‘common’ medical condition can have a wide array of symptoms and that is where even seasoned physicians can have trouble diagnosing the condition.

courtesy: www.medicinenet.com

Consider the following symptoms…

Belly-button pain
Sometimes a patient with discomfort near the belly-button ends up developing appendicitis.

Rapidly worsening pain
Sometimes the patient experiences pain rapidly; unlike anything they have felt before.

Low-grade fever and chills
This set of symptoms could be many things from the flu to appendicitis.

Vomiting, nausea or loss of appetite
Again, another set of symptoms that are found in the flu, food poisoning, and general gastro-intestinal upset.

Constipation, diarrhea, gas or bloating
By now you see the pattern—general symptoms that don’t necessarily point to a problem with the appendix.

Rebound tenderness
This sign, especially occurring with one of the others, does point to an appendicitis. This is where you press down on the abdomen and when you release the pressure pain is felt.

In short, diagnosing an inflamed appendix isn’t as easy as asking the patient or player if he has abdominal pain in the lower right quadrant of his abdomen. Symptoms are different for many patients.

To help determine if the player has an inflamed appendix, the physician will order a CT scan and/or an ultrasound to rule out or diagnose the condition. Lab tests are also performed to determine if the patient is or has developed an infection.

If it is inflamed, surgery is the likely option in most cases. Once the appendix is removed the player/patient begins the rehab program as soon as they are able to tolerate it.

Player examples
This year’s exhibit A (so far) is the Rockies Rafael Betancourt (RHP, COL) who landed on the DL after needing an appendectomy the middle of August. Typically, baseball players need roughly four weeks to recover, which is his timetable. Other recent players affected are Jason Heyward (OF, ATL), who missed 26 days in April, Matt Holliday (OF, STL), who only missed nine days in April 2011 (an obvious outlier here), and Andres Torres (OF, SF), who missed only 12 days in one of the shortest stints for the ailment, but he also struggled with abdominal sores after he came back and clearly should have taken mote time to recover.

A four-week timetable is the most common for appendicitis recovery.

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  For more information about the terms used in this article, see our Glossary Primer.