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A new analysis found that outpatient management of appendicitis with antibiotics is safe for selected patients, which may allow people to avoid hospitalization
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 ...
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.
MRI scan is less readily available than CT scan or ultrasound in hospitals to diagnose IAIs. However, it has been proposed to be used in those who are pregnant and have inconclusive findings on ultrasound. The sensitivity and specificity of MRI in diagnosing acute appendicitis are 94% and 96% respectively. [2]
Omental infarction is a rare cause of acute abdomen pain with reported incidence being less than 4 per 1000 cases of appendicitis. Omental infarction usually presents as right-sided abdominal pain although seldom causing left-sided abdominal pain and even epigastric pain.
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%.
Alvarado scoring has largely been superseded as a clinical prediction tool by the Appendicitis Inflammatory Response score. [ 2 ] [ 3 ] [ 4 ] Also known by the mnemonic MANTRELS, the scale has 6 clinical items (3 signs and 3 symptoms ) and 2 laboratory measurements, each given an additive point score, with a maximum of 10 points possible. [ 5 ]
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]