Summary
Definition
History and exam
Key diagnostic factors
- abdominal pain
- anorexia
- right lower quadrant tenderness
Other diagnostic factors
- age of occurrence
- nausea
- fever
- diminished bowel sounds
- tachycardia
- vomiting
- Rovsing sign
- psoas sign
- obturator sign
Risk factors
- <6 months of breastfeeding
- low dietary fiber
- improved personal hygiene
- smoking
Diagnostic investigations
1st investigations to order
- CBC
- CRP
- abdominal and pelvic CT scan
- urinary pregnancy test
Investigations to consider
- abdominal ultrasound
- urinalysis
- abdominal and pelvic MRI in pregnancy
Treatment algorithm
uncomplicated acute appendicitis
ill with perforation or abscess
Contributors
Authors
Peter Szasz, MD, PhD, FRCSC
Assistant Professor
Department of Surgery
Queen's University
Kingston
Ontario
Canada
Disclosures
PS declares that he has no competing interests.
Acknowledgements
Dr Peter Szasz would like to gratefully acknowledge Professor Ali Tavakkoli, Professor Dileep N. Lobo and Dr Nasim Ahmed, previous contributors to this topic. AT is a consultant for Medtronic. DNL is the author of an article cited in the topic. NA declares that he has no competing interests.
Peer reviewers
John M. Davis, MD
General Surgery
Jersey Shore Medical Center
Neptune
NJ
Disclosures
JMD declares that he has no competing interests.
Differentials
- Acute mesenteric adenitis
- Viral gastroenteritis
- Meckel diverticulitis
More DifferentialsGuidelines
- ACR Appropriateness Criteria: right lower quadrant pain - suspected appendicitis
- WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis
More GuidelinesPatient leaflets
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