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Appendicitis, Acute

Grant Wei, FACEP, MD, Mary E Stuckey, MD and Chirag N. Shah, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Acute inflammation of the appendix

  • Simple or uncomplicated appendicitis occurs when there is no clinical or radiologic sign of perforation. Complicated or perforated appendicitis is d...

DIAGNOSIS

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

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

TREATMENT

GENERAL MEASURES

  • Surgery (appendectomy) has been the standard of care for acute, uncomplicated appendicitis. Evidence suggests nonoperative management with antibiotics may be noninferior to a...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

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

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

REFERENCES

1
Abdella Bahta NN, Zeinert P, Rosenberg J, et al. The Alvarado Score is the Most Impactful Diagnostic Tool for Appendicitis: A Bibliometric Analysis. J Surg Res. 2023;291:557-566. doi: 10.1...

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...

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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