Acute appendicitis

Last reviewed: 18 Apr 2022
Last updated: 11 Jun 2021

Summary

Definition

History and exam

Key diagnostic factors

  • abdominal pain
  • anorexia
  • right lower quadrant tenderness
More key diagnostic factors

Other diagnostic factors

  • age of occurrence
  • nausea
  • fever
  • diminished bowel sounds
  • tachycardia
  • vomiting
  • Rovsing sign
  • psoas sign
  • obturator sign
Other diagnostic factors

Risk factors

  • <6 months of breastfeeding
  • low dietary fiber
  • improved personal hygiene
  • smoking
More risk factors

Diagnostic investigations

1st investigations to order

  • CBC
  • CRP
  • 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

ACUTE

uncomplicated acute appendicitis

ill with perforation or abscess

Contributors

Authors

Peter Szasz, MD, PhD, FRCSC

General and Minimally Invasive Surgeon

Toronto

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.

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