Sometimes it is difficult to diagnose appendicitis, especially in young children, older adults, and pregnant women. Your healthcare provider will review your symptoms and examine you.

You may have the following tests:

• blood tests
• urine tests
• chest X-rays (because pneumonia in the lower right lung can also cause abdominal pain)
• X-ray or ultrasound exam of your belly.

If the diagnosis is not clear or uncertain, you may be watched closely in the emergency room or hospital for 12 to 24 hours to see if surgery is necessary. In most cases the appendix must be removed. The operation is called an appendectomy.
Peritonitis is also treated with surgery and is a medical emergency. A person with symptoms of peritonitis needs to be seen in the emergency department as soon as possible.

A rupture of the appendix can also cause an abscess (infected sore) near the place where the appendix ruptured. If the appendix does rupture, the surgeon may put a drainage tube in the abdomen to let the infection drain from your body for a few days after surgery.

Before surgery you will be given antibiotics. These may be continued 24 hours or many days, depending on whether your appendix ruptured and caused peritonitis.
For the first day or so after surgery, you may not be given anything to eat or drink. Then you will be allowed to have small amounts of water, later clear liquids, and finally some solid food until you are able to handle a regular diet.

Because doctors cannot always be sure that the appendix is inflamed until they examine it during surgery, up to 15% of appendixes that are removed are not inflamed. However, it is appropriate for a provider to risk removal of a normal appendix so that he or she is sure to not miss a case of true appendicitis.

If your doctor does not hospitalize you and sends you home without surgery, your doctor will probably ask you to use no pain medicine. Taking pain medicine could make it difficult for you to know if the pain gets better or worse.  They may ask you not to take antibiotics.   They will want you to contact your doctor if any changes occur in 6 to 12 hours.  

If your doctor sends you home, call your doctor if you have continued or worsening vomiting, increased pain in the abdomen, a higher fever, fainting, or blood in your vomiting or bowel movement.