Last reviewed: 13 Oct 2024
Last updated: 04 Oct 2024
Summary
Definition
History and exam
Key diagnostic factors
- abdominal pain
- anorexia
- nausea and vomiting
- right lower quadrant tenderness
- tense rigid abdomen
- hypotension and tachycardia
- palpable mass
Full details
Other diagnostic factors
- age of occurrence
- fever
- flushed face and a fetor
- diminished bowel sounds
- tachycardia
- loose stool
- constipation
- Rovsing sign
- psoas sign
- obturator sign
Full details
Risk factors
- improved personal hygiene
- smoking
Full details
Diagnostic tests
1st tests to order
- CBC
- CRP
- abdominal and pelvic CT scan
Full details
Tests to consider
- abdominal ultrasound
- urinalysis
- urinary pregnancy test
- abdominal and pelvic MRI in pregnancy
Full details
Emerging tests
- Neutrophil-to-lymphocyte ratio
- serum sodium
- pentraxin-3
- serum amyloid A
- platelet indices
Full details
Treatment algorithm
ACUTE
uncomplicated acute appendicitis
ill with perforation or abscess
Contributors
Expert advisers
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.
Elisabeth Adderson, MD
Associate Member
St. Jude Children's Research Hospital
Associate Professor of Pediatrics
University of Tennessee Health Sciences Center
Memphis
TN
Disclosures
EA declares that she 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
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- Acute abdominal pain
- Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected appendicitis
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