Appendicitis

1 learning resource available for this topic

About Appendicitis

Appendicitis is acute inflammation of the vermiform appendix, typically caused by luminal obstruction leading to bacterial overgrowth and tissue necrosis. It represents one of the most common surgical emergencies, with a lifetime risk of approximately 7-8% and peak incidence in the second and third decades of life.

Pathophysiology

The condition begins with luminal obstruction of the appendix by fecoliths, lymphoid hyperplasia, or foreign bodies, leading to increased intraluminal pressure and compromised blood flow. This creates an environment for bacterial proliferation, progressive inflammation, and potential complications including perforation, abscess formation, and peritonitis if left untreated.

Clinical Reasoning

Classic presentation includes periumbilical pain that migrates to McBurney's point in the right lower quadrant, accompanied by anorexia, nausea, and low-grade fever. Diagnosis relies on clinical assessment supported by laboratory findings (elevated white blood cell count) and imaging studies (CT or ultrasound), with prompt surgical intervention (appendectomy) being the definitive treatment to prevent life-threatening complications.

References

🩻

Imaging Reasoning

CT Abdomen/Pelvis (or US in peds/pregnancy)

Key imaging focus: Dilated appendix >6mm, periappendiceal fat stranding, appendicolith

📚 Radiopaedia Cases →
  1. Appendicitis. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK493193/
  2. ACS Guidelines for Appendicitis. JACS 2022. https://doi.org/10.1016/j.jamcollsurg.2021.09.006
  3. ISTH Guidance on DIC. J Thromb Haemost. https://doi.org/10.1111/jth.14462
  4. WSES Jerusalem Guidelines for Acute Appendicitis. World J Emerg Surg. https://doi.org/10.1186/s13017-020-00306-3
  5. SAGES Guideline for Diagnostic Laparoscopy. Surg Endosc. https://doi.org/10.1007/s00464-018-6542-9

Related Topics

Acute AppendicitisAcute Abdomen