This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Go to /pro/cpd-dashboard page

This page is worth 0.05 CPD credits. CPD dashboard

Go to /account/subscription-details page

This page is worth 0.05 CPD credits. Upgrade to Pro

Acute appendicitis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Acute appendicitis is one of the most common causes of an acute abdomen in the Western world. In 90% of cases the infection develops as a result of obstruction of the appendix, for example, by a faecolith or an engorged lymphoid system, for example by a viral infection.

It is the most common surgical emergency of childhood, with three or four children per 1000 having their appendix removed every year.

This condition can occur at any age but in children it is most often seen over five years of age.

Comparing antibiotic treatment and appendicectomy for acute appendicitis (1,2)

  • surgical appendicectomy remains the best treatment for acute appendicitis in patients fit enough for surgery (1)
  • athough antibiotic treatment can be effective in patients with uncomplicated appendicitis some will still require surgery, which may be more extensive if antibiotics fail and surgery is delayed, and there is a substantial risk of recurrence (1)
    • is possible to categorize acute appendicitis as complicated or uncomplicated (2)
      • an abscess, phlegmon, or perforation are consequences of complicated appendicitis
    • antibiotic regimes in acute uncomplicated appendicitis (2)
      • most popular combination is cephalosporin with nitroimidazole, followed by quinolones and penicillin with a beta-lactamase inhibitor
  • up to 30% of patients treated with firstline antibiotics will require surgery, and there is a substantial risk of recurrence (1)
  • delaying surgery increases the risks of more extensive intervention with associated costs for patients and health system (1)

Reference:

  • Malik A K, Innes A H, Reddy L, Munro C, Phillips A W. Appendicectomy remains treatment of choice for patients with acute appendicitis BMJ 2023; 382 :e074652 doi:10.1136/bmj-2022-0746524
  • Yadao S, Lamture Y, Huse S. Uses of Antibiotics Alone in Case of Uncomplicated Appendicitis. Cureus. 2022 Aug 27;14(8):e28488. doi: 10.7759/cureus.28488. PMID: 36176829; PMCID: PMC9513284

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.