Appendicitis, Acute

Shawn Shaffer, MD and Randy Bain, DO Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Acute inflammation of the vermiform appendix, first described by Reginald Fitz in 1886

  • Arising from the base of the cecum in right lower quadrant (RLQ); can be localized anterior, pos...

DIAGNOSIS

  • Diagnosis of acute appendicitis relies on the history and physical examination with supporting laboratory studies and imaging.

  • Scoring systems

    • Modified Alvarado Scoring System (MASS): The us...

TREATMENT

GENERAL MEASURES

  • Surgery (appendectomy) has been the standard of care for acute, uncomplicated appendicitis. There is growing evidence for medical management in select cases after careful dis...

ONGOING CARE

FOLLOWUP RECOMMENDATIONS

  • Return to work is usually possible 1 to 2 weeks following most uncomplicated appendicitis.

  • Restrict activity for 4 to 6 weeks after surgery: no heavy lifting (>1...

REFERENCES

Hlibczuk V, Dattaro JA, Jin Z et al. Diagnostic accuracy of noncontrast computed tomography for appendicitis in adults: a systematic review. Ann Emerg Med.  2010;55(1):51.e1–59.e1. [V...

ADDITIONAL READING

  • Di Saverio S, Sibilio A, Giorgini E et al. The NOTA Study (Non Operative Treatment for Acute Appendicitis): prospective study on the efficacy and safety of antibiotics (amoxicillin ...

SEE ALSO

Algorithm: Abdominal Rigidity 

CODES

ICD10

  • K35.80 Unspecified acute appendicitis

  • K35.2 Acute appendicitis with generalized peritonitis

  • K35.3 Acute appendicitis with localized peritonitis

  • K35.89 Other acute appendicitis

  • K35 Acute appendi...

PEARLS

  • Classic history of anorexia with periumbilical pain localizing to RLQ is the cornerstone of diagnosis for acute appendicitis.

  • Diagnosis is much more challenging in children, pregnant patients, a...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×