Editing Appendicitis (section)

==Signs and symptoms==
[[File:McBurney's point.jpg|thumb|left|upright=1.3|Location of [[McBurney's point]] (1), located two-thirds the distance from the umbilicus (2) to the right anterior superior iliac spine (3)]]
The presentation of acute appendicitis includes acute abdominal pain, nausea, vomiting, and fever. As the appendix becomes more swollen and inflamed, it begins to irritate the adjoining abdominal wall. This leads the pain to localize at [[Quadrants and regions of abdomen|the right lower quadrant]]. This classic migration of pain may not appear in children under three years. This pain can be triggered by a sharp pain feeling. Pain from appendicitis may begin as dull pain around the navel. After several hours, the pain usually migrates towards the right lower quadrant, where it becomes localized. Symptoms include localized findings in the right [[iliac fossa]]. The abdominal wall becomes very sensitive to gentle pressure ([[palpation]]). There is pain in the sudden release of deep tension in the lower abdomen ([[Blumberg's sign]]). If the appendix is retrocecal (localized behind the [[cecum]]), even deep pressure in the right lower quadrant may fail to elicit tenderness (silent appendix). This is because the [[cecum]], distended with gas, protects the inflamed appendix from pressure. Similarly, if the appendix lies entirely within the pelvis, there is typically a complete absence of abdominal rigidity. In such cases, a digital [[rectal examination]] elicits tenderness in the rectovesical pouch. Coughing causes point tenderness in this area ([[McBurney's point]]), called [[Dunphy's sign]].{{medical citation needed|date=August 2023}}