Diagnosis

Appendicitis

Etiology

Cause [ums]

• Fecalitis

• Infection in the GI (E coli, Peptostreptococcus, Bacteroides, and Pseudomonas)

• Inflammation (Morbus Crohn or ulcerative colitis)

• Tumors (adenocarcinoma, mucocele, and carcinoid tumor)

Pathophysiology [ums]

• Luminal obstruction -> Distention -> Venous congestion -> Inflammation and ischemia

Complications

• Perforation

• Abscess

• Sepsis

Epidemiology

Incidence per 100.000 [sua][ihm][ef4]

Approach

• Blood test

• Urine stix

• Abdominal x-ray

• Ultrasound abdomen

• CT abdomen

• Diagnostic laparoscopy

Treatment

1. Acute appendicitis -> Appendectomy [gbm]

2. Phlegmon/small abscess:

   • Intravenous antibiotic therapy

   • Later appendectomy can be performed after 4-6 weeks

3. Larger well-defined abscess:

   • Percutaneous drainage

   • IV antibiotics

   • Later interval appendectomy can be performed after the fistula is closed

Differential diagnoses

Aortic dissection, Gastroenteritis, Gastrointestinal perforation, Intussusception, Meckels diverticulum, Mesenteric adenitis, Neutropenic colitis, Ovarian cancer, Ovarian torsion, Pelvic inflammatory disease, Peritonitis, Pyelonephritis, Ruptured aortic aneurysm, Ruptured ectopic pregnancy, Ruptured ovarian cyst, Spontaneous bacterial peritonitis, Typhoid fever, Urinary tract infection, Urolithiasis