Acute Appendicitis

- Introduction

Acute abdominal pain accounts for 7–10% of all emergency department accesses. Acute appendicitis (AA) is among the most common causes of lower abdominal pain leading patients to attend the emergency department and the most common diagnosis made in young patients admitted to the hospital with an acute abdomen⁽¹⁾.

The rate of perforation varies from 16% to 40%, with a higher frequency occurring in younger age groups (40–57%) and in patients older than 50 years (55–70%) ⁽¹⁾.

Appendiceal perforation is associated with increased morbidity and mortality compared with non-perforating AA. The mortality risk of acute but not gangrenous AA is less than 0.1%, but the risk rises to 0.6% in gangrenous AA. On the other hand, perforated AA carries a higher mortality rate of around 5% ⁽²⁾.

Currently, growing evidence suggests that perforation is not necessarily the inevitable result of appendiceal obstruction, and an increasing amount of evidence now suggests not only that not all patients with AA will progress to perforation, but even that resolution may be a common event⁽³⁾.