Last reviewed: March 2020
Last updated: March  2020



History and exam

Key diagnostic factors

  • abdominal pain
  • anorexia
  • right lower quadrant tenderness

Other diagnostic factors

  • adolescence or early adulthood
  • nausea
  • fever
  • diminished bowel sounds
  • tachycardia
  • fetor
  • vomiting
  • Rovsing's sign
  • psoas sign
  • obturator sign

Risk factors

  • <6 months of breastfeeding
  • low dietary fibre
  • improved personal hygiene
  • smoking

Diagnostic investigations

1st investigations to order

  • FBC
  • abdominal and pelvic CT scan
  • urinary pregnancy test
More 1st investigations to order

Investigations to consider

  • abdominal ultrasound
  • urinalysis
  • abdominal and pelvic MRI in pregnancy
More investigations to consider

Treatment algorithm


Dileep N. Lobo

Professor of Gastrointestinal Surgery

National Institute for Health Research, Nottingham Digestive Diseases Biomedical Research Unit Nottingham University Hospitals and University of Nottingham, Queen's Medical Centre




DNL declares that he has no competing interests. DNL is the author of an article cited in the topic.

Professor Dileep N. Lobo would like to gratefully acknowledge Dr Nasim Ahmed, a previous contributor to this topic. NA declares that he has no competing interests.

Peer reviewersVIEW ALL

General Surgery

Jersey Shore Medical Center




JMD declares that he has no competing interests.

Use of this content is subject to our disclaimer