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Appendicitis

MedGen UID:
1630
•Concept ID:
C0003615
•
Disease or Syndrome
Synonyms: Acute Appendicitis; appendicitis; inflammation of vermiform appendix; vermiform appendix inflammation
SNOMED CT: Appendicitis (74400008)
 
HPO: HP:6000143
Monarch Initiative: MONDO:0005649

Definition

Appendicitis is inflammation of the vermiform appendix. Appendix a hollow organ located at the tip of the cecum, usually in the right lower quadrant of the abdomen. [from HPO]

Professional guidelines

PubMed

Diagnosis and Management of Acute Appendicitis in Adults: A Review.
Moris D, Paulson EK, Pappas TN
JAMA 2021 Dec 14;326(22):2299-2311. doi: 10.1001/jama.2021.20502. PMID: 34905026
Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines.
Di Saverio S, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A, Boermeester M, Sartelli M, Coccolini F, Tarasconi A, De' Angelis N, Weber DG, Tolonen M, Birindelli A, Biffl W, Moore EE, Kelly M, Soreide K, Kashuk J, Ten Broek R, Gomes CA, Sugrue M, Davies RJ, Damaskos D, Leppäniemi A, Kirkpatrick A, Peitzman AB, Fraga GP, Maier RV, Coimbra R, Chiarugi M, Sganga G, Pisanu A, De' Angelis GL, Tan E, Van Goor H, Pata F, Di Carlo I, Chiara O, Litvin A, Campanile FC, Sakakushev B, Tomadze G, Demetrashvili Z, Latifi R, Abu-Zidan F, Romeo O, Segovia-Lohse H, Baiocchi G, Costa D, Rizoli S, Balogh ZJ, Bendinelli C, Scalea T, Ivatury R, Velmahos G, Andersson R, Kluger Y, Ansaloni L, Catena F
World J Emerg Surg 2020 Apr 15;15(1):27. doi: 10.1186/s13017-020-00306-3. PMID: 32295644Free PMC Article
Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management.
Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT
Lancet 2015 Sep 26;386(10000):1278-1287. doi: 10.1016/S0140-6736(15)00275-5. PMID: 26460662

Recent clinical studies

Etiology

Appendicitis in Children.
Gil LA, Deans KJ, Minneci PC
Adv Pediatr 2023 Aug;70(1):105-122. Epub 2023 May 10 doi: 10.1016/j.yapd.2023.03.003. PMID: 37422289
Diagnosis of Uncomplicated and Complicated Appendicitis in Adults.
Bom WJ, Scheijmans JCG, Salminen P, Boermeester MA
Scand J Surg 2021 Jun;110(2):170-179. Epub 2021 Apr 14 doi: 10.1177/14574969211008330. PMID: 33851877Free PMC Article
Acute Appendicitis in Childhood and Adulthood.
Téoule P, Laffolie J, Rolle U, Reissfelder C
Dtsch Arztebl Int 2020 Nov 6;117(45):764-774. doi: 10.3238/arztebl.2020.0764. PMID: 33533331Free PMC Article
Evaluation of Alvarado score in diagnosing acute appendicitis.
Awayshih MMA, Nofal MN, Yousef AJ
Pan Afr Med J 2019;34:15. Epub 2019 Sep 6 doi: 10.11604/pamj.2019.34.15.17803. PMID: 31762884Free PMC Article
Acute Appendicitis: Efficient Diagnosis and Management.
Snyder MJ, Guthrie M, Cagle S
Am Fam Physician 2018 Jul 1;98(1):25-33. PMID: 30215950

Diagnosis

Update on acute appendicitis: Typical and untypical findings.
Borruel Nacenta S, Ibáñez Sanz L, Sanz Lucas R, Depetris MA, Martínez Chamorro E
Radiologia (Engl Ed) 2023 Mar;65 Suppl 1:S81-S91. doi: 10.1016/j.rxeng.2022.09.010. PMID: 37024234
Evolution and Current Trends in the Management of Acute Appendicitis.
Wagner M, Tubre DJ, Asensio JA
Surg Clin North Am 2018 Oct;98(5):1005-1023. Epub 2018 Jul 13 doi: 10.1016/j.suc.2018.05.006. PMID: 30243444
Acute Appendicitis: Efficient Diagnosis and Management.
Snyder MJ, Guthrie M, Cagle S
Am Fam Physician 2018 Jul 1;98(1):25-33. PMID: 30215950
Appendicitis.
D'Souza N, Nugent K
Am Fam Physician 2016 Jan 15;93(2):142-3. PMID: 26926413
Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management.
Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT
Lancet 2015 Sep 26;386(10000):1278-1287. doi: 10.1016/S0140-6736(15)00275-5. PMID: 26460662

Therapy

Role of preoperative in-hospital delay on appendiceal perforation while awaiting appendicectomy (PERFECT): a Nordic, pragmatic, open-label, multicentre, non-inferiority, randomised controlled trial.
Jalava K, Sallinen V, Lampela H, Malmi H, Steinholt I, Augestad KM, Leppäniemi A, Mentula P
Lancet 2023 Oct 28;402(10412):1552-1561. Epub 2023 Sep 14 doi: 10.1016/S0140-6736(23)01311-9. PMID: 37717589
Conservative treatment of acute appendicitis.
Coccolini F, Fugazzola P, Sartelli M, Cicuttin E, Sibilla MG, Leandro G, De' Angelis GL, Gaiani F, Di Mario F, Tomasoni M, Catena F, Ansaloni L
Acta Biomed 2018 Dec 17;89(9-S):119-134. doi: 10.23750/abm.v89i9-S.7905. PMID: 30561405Free PMC Article
Comparison of Antibiotic Therapy and Appendectomy for Acute Uncomplicated Appendicitis in Children: A Meta-analysis.
Huang L, Yin Y, Yang L, Wang C, Li Y, Zhou Z
JAMA Pediatr 2017 May 1;171(5):426-434. doi: 10.1001/jamapediatrics.2017.0057. PMID: 28346589Free PMC Article
Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis: The APPAC Randomized Clinical Trial.
Salminen P, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Tuominen R, Hurme S, Virtanen J, Mecklin JP, Sand J, Jartti A, Rinta-Kiikka I, Grönroos JM
JAMA 2015 Jun 16;313(23):2340-8. doi: 10.1001/jama.2015.6154. PMID: 26080338
Controversies in appendicitis.
Meeks DW, Kao LS
Surg Infect (Larchmt) 2008 Dec;9(6):553-8. doi: 10.1089/sur.2008.9954. PMID: 19216665

Prognosis

Trends and levels of the global, regional, and national burden of appendicitis between 1990 and 2021: findings from the Global Burden of Disease Study 2021.
GBD 2021 Appendicitis Collaborator Group
Lancet Gastroenterol Hepatol 2024 Sep;9(9):825-858. Epub 2024 Jul 17 doi: 10.1016/S2468-1253(24)00157-2. PMID: 39032499Free PMC Article
Incidence and severity of pediatric appendicitis during the COVID‑19 pandemic.
Quaglietta PR, Baertschiger RM
World J Pediatr 2023 Jul;19(7):710-712. Epub 2023 Apr 11 doi: 10.1007/s12519-023-00712-y. PMID: 37039925Free PMC Article
Influence of overweight and obesity on acute appendicitis in children. A cohort study.
Delgado-Miguel C, Muñoz-Serrano AJ, Barrena Delfa S, Núñez Cerezo V, Velayos M, Estefanía K, Bueno Jiménez A, Martínez L
Cir Pediatr 2020 Jan 20;33(1):20-24. PMID: 32166919
Complicated appendicitis and considerations for interval appendectomy.
Perez KS, Allen SR
JAAPA 2018 Sep;31(9):35-41. doi: 10.1097/01.JAA.0000544304.30954.40. PMID: 30153202
Appendicitis.
D'Souza N
BMJ Clin Evid 2011 Jan 7;2011 PMID: 21477397Free PMC Article

Clinical prediction guides

Neutrophil-to-lymphocyte ratio predicts acute appendicitis and distinguishes between complicated and uncomplicated appendicitis: A systematic review and meta-analysis.
Hajibandeh S, Hajibandeh S, Hobbs N, Mansour M
Am J Surg 2020 Jan;219(1):154-163. Epub 2019 Apr 27 doi: 10.1016/j.amjsurg.2019.04.018. PMID: 31056211
Evaluation of Alvarado score in diagnosing acute appendicitis.
Awayshih MMA, Nofal MN, Yousef AJ
Pan Afr Med J 2019;34:15. Epub 2019 Sep 6 doi: 10.11604/pamj.2019.34.15.17803. PMID: 31762884Free PMC Article
Can Surgeons Identify Appendicitis Macroscopically? Results From a Multicentre Prospective Study.
Thong DW, Crouch S, Morgan S, Arthur T; QUEST Collaboration
Surg Laparosc Endosc Percutan Tech 2019 Oct;29(5):344-348. doi: 10.1097/SLE.0000000000000687. PMID: 31166292
Overview and diagnosis of acute appendicitis in children.
Glass CC, Rangel SJ
Semin Pediatr Surg 2016 Aug;25(4):198-203. Epub 2016 May 10 doi: 10.1053/j.sempedsurg.2016.05.001. PMID: 27521708
CT and sonographic evaluation of acute right lower quadrant abdominal pain.
Birnbaum BA, Jeffrey RB Jr
AJR Am J Roentgenol 1998 Feb;170(2):361-71. doi: 10.2214/ajr.170.2.9456947. PMID: 9456947

Recent systematic reviews

SAGES guideline for the diagnosis and treatment of appendicitis.
Kumar SS, Collings AT, Lamm R, Haskins IN, Scholz S, Nepal P, Train AT, Athanasiadis DI, Pucher PH, Bradley JF 3rd, Hanna NM, Quinteros F, Narula N, Slater BJ
Surg Endosc 2024 Jun;38(6):2974-2994. Epub 2024 May 13 doi: 10.1007/s00464-024-10813-y. PMID: 38740595
Diagnosis and treatment of appendicitis: systematic review and meta-analysis.
Lamm R, Kumar SS, Collings AT, Haskins IN, Abou-Setta A, Narula N, Nepal P, Hanna NM, Athanasiadis DI, Scholz S, Bradley JF 3rd, Train AT, Pucher PH, Quinteros F, Slater B
Surg Endosc 2023 Dec;37(12):8933-8990. Epub 2023 Nov 1 doi: 10.1007/s00464-023-10456-5. PMID: 37914953
Nonoperative vs Operative Management of Uncomplicated Acute Appendicitis: A Systematic Review and Meta-analysis.
de Almeida Leite RM, Seo DJ, Gomez-Eslava B, Hossain S, Lesegretain A, de Souza AV, Bay CP, Zilberstein B, Marchi E, Machado RB, Barchi LC, Ricciardi R
JAMA Surg 2022 Sep 1;157(9):828-834. doi: 10.1001/jamasurg.2022.2937. PMID: 35895073Free PMC Article
Diagnosis and management of acute appendicitis. EAES consensus development conference 2015.
Gorter RR, Eker HH, Gorter-Stam MA, Abis GS, Acharya A, Ankersmit M, Antoniou SA, Arolfo S, Babic B, Boni L, Bruntink M, van Dam DA, Defoort B, Deijen CL, DeLacy FB, Go PM, Harmsen AM, van den Helder RS, Iordache F, Ket JC, Muysoms FE, Ozmen MM, Papoulas M, Rhodes M, Straatman J, Tenhagen M, Turrado V, Vereczkei A, Vilallonga R, Deelder JD, Bonjer J
Surg Endosc 2016 Nov;30(11):4668-4690. Epub 2016 Sep 22 doi: 10.1007/s00464-016-5245-7. PMID: 27660247Free PMC Article
Meckel's diverticulum-Revisited.
Malik AA; Shams-ul-Bari, Wani KA, Khaja AR
Saudi J Gastroenterol 2010 Jan-Mar;16(1):3-7. doi: 10.4103/1319-3767.58760. PMID: 20065566Free PMC Article

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