Appendicitis

How common is appendicitis?

 Appendicitis is the most common abdominal
emergency and accounts for more than 40 000
hospital admissions in England every year.
 Appendicitis is most common between the
ages of 10 and 20 years, but no age is exempt.
 A male preponderance exists, with a male to
female ratio of 1.4:1; the overall lifetime risk is
8.6% for males and 6.7% for females in the
United States.
How do I diagnose it?
Diagnosis of acute appendicitis relies on a
thorough history and examination.
What investigations might help?
Differential diagnosis
How do I treat it?
 Herbert Fitz was the first author to publish on the
need for early diagnosis and surgery for acute
appendicitis.
 No good evidence exists to support the notion
that analgesia should be withheld on the grounds
that it may cloud the clinical picture.
 All patients should receive broad spectrum
perioperative antibiotics (one to three doses), as
they have been shown to decrease the incidence
of postoperative wound infection and intra-
abdominal abscess formation.
What are the complications?
 Despite this, complications can occur after
removal of a normal appendix, and the
surgical community continues to strive to
reduce the numbers of negative procedures.
 According to a large historical cohort study,
a perforated appendix during childhood
does not seem to have a long term
detrimental effect on subsequent female
fertility