Acute appendicitis

Acute appendicitis typically presents as acute abdominal pain starting in the mid-abdomen and later localizing to the right lower quadrant.

Associated with fever, anorexia, nausea, vomiting, and elevation of the neutrophil count.

Diagnosis is usually made clinically. If investigation is required, computed tomography scan or ultrasonography may show dilatation of the appendix outer diameter to more than 6 mm.

Definitive treatment is surgical appendectomy. A nonoperative, antibiotic-only approach may be feasible in select patient populations.

Acute appendicitis is an acute inflammation of the vermiform appendix, most likely due to obstruction of the lumen of the appendix (by fecalith, normal stool, infective agents, or lymphoid hyperplasia).[1]Fitz RH. Perforating inflammation of the vermiform appendix with special reference to its early diagnosis and treatment. Am J Med Sci. 1886;92:321-46.[2]Moris D, Paulson EK, Pappas TN. Diagnosis and management of acute appendicitis in adults: A Review. JAMA. 2021 Dec 14;326(22):2299-311. http://www.ncbi.nlm.nih.gov/pubmed/34905026?tool=bestpractice.com [Figure caption and citation for the preceding image starts]: Acute appendicitis - intraoperative specimen.Nasim Ahmed, MBBS, FACS; used with permission [Citation ends].​​​