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The presentation of acute appendicitis includes acute abdominal pain, nausea, vomiting, and fever. As the appendix becomes more swollen and inflamed, it begins to irritate the adjoining abdominal wall. This leads the pain to localize at the right lower quadrant. This classic migration of pain may not appear in children under three years.
The AIR score was developed to overcome some of the drawbacks of the Alvarado score, another diagnostic scoring system for identifying appendicitis. [2] The AIR score is one of the two scores (the other being the Adult Appendicitis Score , AAS) recommended by the 2020 World Society of Emergency Surgery clinical practice guidelines for the ...
A new analysis found that outpatient management of appendicitis with antibiotics is safe for selected patients, which may allow people to avoid hospitalization
The sensitivity and specificity of MRI in diagnosing acute appendicitis are 94% and 96% respectively. [2] Laparoscopic surgery has also been used to diagnose the cause of IAIs when imaging is unhelpful. Besides, the laparoscopic surgery can also initiate treatment in the same setting. The accuracy is very high, in the range of 86 to 100%. [2]
Appendicitis develops most commonly in the second trimester. [2] If appendicitis develops in a pregnant woman, an appendectomy is usually performed and should not harm the fetus. [15] The risk of premature delivery is about 10%. [16] The risk of fetal death in the perioperative period after an appendectomy for early acute appendicitis is 3 to 5%.
Treatment is with antibiotics and drainage of the abscess; typically guided by ultrasound or CT, through the skin, via the rectum, or transvaginal routes. [3] Occasionally antibiotics may be used without surgery; if the abscess is at a very stage and small. [2] Until sensitivities are received, a broad spectrum antibiotic is generally required. [2]
Appendicitis is one of the most common, and significant causes of severe abdominal pain, that comes on quickly. In 2015, about 11.6 million cases of appendicitis occurred, which resulted in about 50,100 deaths. [11] [12]
Common causes of an acute abdomen include a gastrointestinal perforation, peptic ulcer disease, mesenteric ischemia, acute cholecystitis, appendicitis, diverticulitis, pancreatitis, and an abdominal hemorrhage. However, this is a non-exhaustative list and other less common causes may also lead to an acute abdomen. [2]
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