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Appendicitis, Acute

Cragin D. Currence, MD and Caleb J. Mentzer, DO Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Acute inflammation of the appendix

  • Arising from the base of the cecum in right lower quadrant (RLQ), the appendix can be anterior, posterior, medial, or lateral to the cecum as well a...

DIAGNOSIS

  • Diagnosis relies on history and physical examination with supporting laboratory studies and imaging.

  • Scoring systems

    • Modified Alvarado Scoring System (MASS): The use of MASS in the diagnosis o...

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—antibiotic therap...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Return to work in 1 to 2 weeks is typically following most cases of uncomplicated appendicitis.

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

REFERENCES

1
Benedetto G, Ferrer Puchol MD, Llavata Solaz A. Suspicion of acute appendicitis in adults. The value of ultrasound in our hospital. Radiologia.  2019;61(1):51–59. [View Abstract on Ov...

ADDITIONAL READING

Bhangu A, Søreide K, Di Saverio S, et al. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet.  2015;386(10000):1278–1287. [View Abstrac...

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...

CLINICAL PEARLS

  • Anorexia with periumbilical pain localizing to RLQ is the classic history for acute appendicitis.

  • Diagnosis is more challenging in children, pregnant patients, and the elderly due to va...

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