Abdominal pain is a main acute appendicitis symptom. It arises from the very beginning, along with appetite loss. The discomfort gradually increases. Pain at first develops in the top or periomphalic areas of stomach, disperses from it around, can stop and renew, is difficult define an exact of its main source location. Such beginning is an important detail at patient inquiry. Seldom, the pain at appendicitis is intensive from the very beginning, and if it at first appeared in the right side below, the reason of it, most likely, is not an acute appendicitis.
At inspection of the patient at an early stage the changes are not seen. Analyses remain normal. The patient can be sent home, having suspected a nonsurgical disease or neurosis. If the person was awakened by pain during a deep sleep, it is necessary to show consideration for his complaints and to exclude the acute appendicitis.
Within the period from 4 to 48 hours pain moves from periomphalic area to the right lower area of a stomach. Its intensity is mild or moderate. Since then most of patients feel rather sick. If the disease arose in the afternoon, the person asks for a medical care, stops his work.
In case of indistinctive location of vermiform appendix, the pain in the right top area of stomach prevails, this is the reason of wrong diagnosis – cholecystitis. In two-three days in the absence of surgical treatment symptoms of an appendicitis give way to symptoms of perforation of vermiform appendix. If the pain, which is not very sharp, proceeds for many days, it means the availability of other disease.