Abstract
Patients with suspicion of acute appendicitis are common, especially among children and young adults and in men. The diagnosis is often difficult and the spectrum of the disease is wide, from the mild, often spontaneous resolving cases, to the septic patient with generalised peritonitis that need emergent surgery. This motivates a risk stratified management based on a clinical score. Evalution for emergent surgical treatment should be done in patients with high probability of appendicitis. Repeat clinical and laboratory examination after a few hours of observation followed by eventual selective imaging is recommended in patients with low or intermediate probability of appendicitis. Imaging has a higher priority in the elderly and patients with longer duration of symptoms as other differential diagnoses need to be considered. Antibiotics treatment is indicated in patients with abscess or phlegmone.
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References
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Andersson, R.E. (2016). Acute Appendicitis: Diagnosis and Nonoperative Management. In: Di Saverio, S., Catena, F., Ansaloni, L., Coccolini, F., Velmahos, G. (eds) Acute Care Surgery Handbook. Springer, Cham. https://doi.org/10.1007/978-3-319-15362-9_22
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DOI: https://doi.org/10.1007/978-3-319-15362-9_22
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