Acute appendicitis

doi:10.1136/bmj.38940.664363.AE

BMJ 2006;333:530-534 (9 September), doi:10.1136/bmj.38940.664363.AE

Clinical review

Acute appendicitis

D J Humes, Research into Ageing/Royal College of Surgeons of England research fellow¹, J Simpson, lecturer in surgery¹

¹ Division of Gastrointestinal Surgery, Section of Surgery, University Hospital, Queen's Medical Centre, Nottingham NG7 2UH

Correspondence to: J Simpson j.simpson@nottingham.ac.uk

The first 150 words of the full text of this article appear below.

Introduction

The diagnosis of acute appendicitis is predominantly a clinicalone; many patients present with a typical history and examinationfindings. The cause of acute appendicitis is unknown but isprobably multifactorial; luminal obstruction and dietary andfamilial factors have all been suggested.¹ Appendicectomy isthe treatment of choice and is increasingly done as a laparoscopicprocedure. This article reviews the presentation, investigation,treatment, and complications of acute appendicitis and appendicectomy.

How common is appendicitis?

Appendicitis is the most common abdominal emergency and accountsfor more than 40 000 hospital admissions in England every year.²Appendicitis is most common between the ages of 10 and 20 years,but no age is exempt.³ A male preponderance exists, with a maleto female ratio of 1.4:1; the overall lifetime risk is 8.6%for males and 6.7% for females in the United States.³ Sincethe 1940s the incidence of hospital admission for acute appendicitishas been falling, but . . . [Full text of this article]

How do I diagnose it?

What investigations might help?

Differential diagnosis

How do I treat it?

What are the complications?

Special considerations

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