Appendicitis: A medical serious condition - An updated review
Keywords:
appendicitis, diagnosis, imaging, atypical symptoms, perforation, appendectomyAbstract
Background: Appendicitis, an inflammation of the appendix, is a prevalent medical condition with varied clinical presentations. It primarily affects individuals between 5 and 45 years of age, with a higher incidence in males. Although appendicitis is common in Western countries, its rates are increasing in developing regions. Aim: This updated review aims to explore the clinical presentations, diagnostic approaches, and risk factors of appendicitis, with a focus on typical and atypical signs, as well as the role of imaging in diagnosis. Methods: A comprehensive literature review was conducted, incorporating studies on appendicitis risk factors, diagnostic challenges, and therapeutic strategies. Data on clinical presentations, anatomical variations, and the effectiveness of imaging modalities were examined. Results: The review highlights that typical symptoms of appendicitis include migratory pain, anorexia, nausea, and fever, but atypical presentations are common in children, the elderly, and pregnant women. Delayed diagnosis in these groups can lead to complications such as perforation and peritonitis. Diagnostic imaging, including ultrasonography, CT scans, and MRI, plays a crucial role in identifying appendicitis, with CT scans being the gold standard.
Downloads
References
Biofilms in the large bowel suggest an apparent function of the human vermiform appendix. Bollinger RR, Barbas AS, Bush EL, Lin SS, Parker W. J Theor Biol. 2007;249:826–831. doi: 10.1016/j.jtbi.2007.08.032. DOI: https://doi.org/10.1016/j.jtbi.2007.08.032
Jones MW, Lopez RA, Deppen JG. Treasure Island (FL): StatPearls Publishing; 2022. Appendicitis.
The global incidence of appendicitis: a systematic review of population-based studies. Ferris M, Quan S, Kaplan BS, et al. Ann Surg. 2017;266:237–241. doi: 10.1097/SLA.0000000000002188. DOI: https://doi.org/10.1097/SLA.0000000000002188
The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition) Fugazzola P, Ceresoli M, Agnoletti V, et al. World J Emerg Surg. 2020;15:19. doi: 10.1186/s13017-020-00298-0. DOI: https://doi.org/10.1186/s13017-020-00298-0
Weledji EP. Appendicitis - Causes and Treatments. IntechOpen; 2022. Appendicitis: Epidemiology, Evaluation, and Controversy in Management.
The epidemiology of appendicitis and appendectomy in the United States. Addiss DG, Shaffer N, Fowler BS, Tauxe RV. Am J Epidemiol. 1990;132:910–925. doi: 10.1093/oxfordjournals.aje.a115734. DOI: https://doi.org/10.1093/oxfordjournals.aje.a115734
Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Lancet. 2015;386:1278–1287. doi: 10.1016/S0140-6736(15)00275-5. DOI: https://doi.org/10.1016/S0140-6736(15)00275-5
Racial and ethnic disparities in the delayed diagnosis of appendicitis among children. Goyal MK, Chamberlain JM, Webb M, et al. Acad Emerg Med. 2021;28:949–956. doi: 10.1111/acem.14142. DOI: https://doi.org/10.1111/acem.14142
Do racial/ethnic and economic factors affect the rate of complicated appendicitis in children? Totapally A, Martinez P, Raszynski A, Alkhoury F, Totapally BR. Surg Res Pract. 2020;2020:3268567. doi: 10.1155/2020/3268567 DOI: https://doi.org/10.1155/2020/3268567
The effect of race on outcomes for appendicitis in children: a nationwide analysis. Zwintscher NP, Steele SR, Martin MJ, Newton CR. Am J Surg. 2014;207:748–753. doi: 10.1016/j.amjsurg.2013.12.020. DOI: https://doi.org/10.1016/j.amjsurg.2013.12.020
Equal access to healthcare does not eliminate disparities in the management of adults with appendicitis. Lee SL, Yaghoubian A, Stark R, Shekherdimian S. J Surg Res. 2011;170:209–213. doi: 10.1016/j.jss.2011.02.009. DOI: https://doi.org/10.1016/j.jss.2011.02.009
Acute appendicitis in young children less than 5 years: review article. Almaramhy HH. Ital J Pediatr. 2017;43:15. doi: 10.1186/s13052-017-0335-2. DOI: https://doi.org/10.1186/s13052-017-0335-2
Acute appendicitis. Stringer MD. J Paediatr Child Health. 2017;53:1071–1076. doi: 10.1111/jpc.13737 DOI: https://doi.org/10.1111/jpc.13737
Acute appendicitis, inflammatory appendiceal mass and the risk of a hidden malignant tumor: a systematic review of the literature. Teixeira FJ Jr, Couto Netto SD, Akaishi EH, Utiyama EM, Menegozzo CA, Rocha MC. World J Emerg Surg. 2017;12:12. doi: 10.1186/s13017-017-0122-9. DOI: https://doi.org/10.1186/s13017-017-0122-9
Non-operative management of acute appendicitis in children. Jumah S, Wester T. Pediatr Surg Int. 2022;39:11. doi: 10.1007/s00383-022-05284-y. DOI: https://doi.org/10.1007/s00383-022-05284-y
Genetic and environmental influences on the risk of acute appendicitis in twins. Sadr Azodi O, Andrén-Sandberg A, Larsson H. Br J Surg. 2009;96:1336–1340. doi: 10.1002/bjs.6736. DOI: https://doi.org/10.1002/bjs.6736
Examining a common disease with unknown etiology: trends in epidemiology and surgical management of appendicitis in California, 1995-2009. Anderson JE, Bickler SW, Chang DC, Talamini MA. World J Surg. 2012;36:2787–2794. doi: 10.1007/s00268-012-1749-z DOI: https://doi.org/10.1007/s00268-012-1749-z
Familial risk of appendicitis: a nationwide population study. Li HM, Yeh LR, Huang YK, Hsieh MY, Yu KH, Kuo CF. J Pediatr. 2018;203:330–335. doi: 10.1016/j.jpeds.2018.07.071. DOI: https://doi.org/10.1016/j.jpeds.2018.07.071
Fiber intake and childhood appendicitis. Adamidis D, Roma-Giannikou E, Karamolegou K, Tselalidou E, Constantopoulos A. Int J Food Sci Nutr. 2000;51:153–157. doi: 10.1080/09637480050029647. DOI: https://doi.org/10.1080/09637480050029647
Diet, infection, and acute appendicitis in Britain and Ireland. Morris J, Barker DJ, Nelson M. J Epidemiol Community Health. 1987;41:44–49. doi: 10.1136/jech.41.1.44. DOI: https://doi.org/10.1136/jech.41.1.44
Association of appendicitis incidence with warmer weather independent of season. Simmering JE, Polgreen LA, Talan DA, Cavanaugh JE, Polgreen PM. JAMA Netw Open. 2022;5:0. doi: 10.1001/jamanetworkopen.2022.34269. DOI: https://doi.org/10.1001/jamanetworkopen.2022.34269
Dietary fibre and acute appendicitis: a case-control study. Nelson M, Barker DJ, Winter PD. https://pubmed.ncbi.nlm.nih.gov/6086550/ Hum Nutr Appl Nutr. 1984;38:126–131.
Effect of ambient air pollution on the incidence of appendicitis. Kaplan GG, Dixon E, Panaccione R, et al. CMAJ. 2009;181:591–597. doi: 10.1503/cmaj.082068. DOI: https://doi.org/10.1503/cmaj.082068
Seasonal variation in onset of acute appendicitis. Gallerani M, Boari B, Anania G, Cavallesco G, Manfredini R. https://europepmc.org/article/med/16817501. Clin Ter. 2006;157:123–127.
Summer appendicitis. Fares A. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952290/ Ann Med Health Sci Res. 2014;4:18–21. doi: 10.4103/2141-9248.126603. DOI: https://doi.org/10.4103/2141-9248.126603
Case series of acute appendicitis association with SARS-CoV-2 infection. Prichard C, Canning M, McWilliam-Ross K, Birbari J, Parker W, Wasson L, Hollingsworth JW. BMC Infect Dis. 2021;21:217. doi: 10.1186/s12879-021-05909-y. DOI: https://doi.org/10.1186/s12879-021-05909-y
Risks of complicated acute appendicitis in patients with psychiatric disorders. Kim J, Yang C, Joo HJ, et al. BMC Psychiatry. 2022;22:763. doi: 10.1186/s12888-022-04428-7. DOI: https://doi.org/10.1186/s12888-022-04428-7
Acute appendicitis. Humes DJ, Simpson J. BMJ. 2006;333:530–534. doi: 10.1136/bmj.38940.664363.AE. DOI: https://doi.org/10.1136/bmj.38940.664363.AE
Pediatric appendicitis: age does make a difference. Aneiros B, Cano I, García A, Yuste P, Ferrero E, Gómez A. Rev Paul Pediatr. 2019;37:318–324. doi: 10.1590/1984-0462/;2019;37;3;00019. DOI: https://doi.org/10.1590/1984-0462/;2019;37;3;00019
Acute appendicitis in infants: still a diagnostic dilemma. Cherian MP, Al Egaily KA, Joseph TP. Ann Saudi Med. 2003;23:187–190. doi: 10.5144/0256-4947.2003.187. DOI: https://doi.org/10.5144/0256-4947.2003.187
Appendicitis in children less than five years old: a challenge for the general practitioner. Marzuillo P, Germani C, Krauss BS, Barbi E. World J Clin Pediatr. 2015;4:19–24. doi: 10.5409/wjcp.v4.i2.19. DOI: https://doi.org/10.5409/wjcp.v4.i2.19
Does this child have appendicitis? . Bundy DG, Byerley JS, Liles EA, Perrin EM, Katznelson J, Rice HE. Jama. 2007;298:438–451. doi: 10.1001/jama.298.4.438. DOI: https://doi.org/10.1001/jama.298.4.438
Acute appendicitis: efficient diagnosis and management. Snyder MJ, Guthrie M, Cagle S. https://pubmed.ncbi.nlm.nih.gov/30215950/ Am Fam Physician. 2018;98:25–33.
The influence of age, duration of symptoms and duration of operation on outcome after appendicitis in children. Bech-Larsen SJ, Lalla M, Thorup JM. https://pubmed.ncbi.nlm.nih.gov/23905565/ Dan Med J. 2013;60:0.
Acute appendicitis: the reliability of diagnosis by clinical assessment alone. Kalliakmanis V, Pikoulis E, Karavokyros IG, et al. Scand J Surg. 2005;94:201–206. doi: 10.1177/145749690509400305. DOI: https://doi.org/10.1177/145749690509400305
Acute appendicitis: current diagnosis and treatment. Shelton T, McKinlay R, Schwartz RW. Curr Surg. 2003;60:502–505. doi: 10.1016/S0149-7944(03)00131-4. DOI: https://doi.org/10.1016/S0149-7944(03)00131-4
Acute perforated appendicitis associated with appendiceal diverticulitis in a young man: a case report with literature review. Abdulmomen AA, AlZahrani AS, Al Mulla LA, Alaqeel FO. Am J Case Rep. 2022;23:0–7. doi: 10.12659/AJCR.934838. DOI: https://doi.org/10.12659/AJCR.934838
A simple case of appendicitis? an increasingly recognised pitfall. Chand M, Moore PJ, Nash GF. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2121262/ Ann R Coll Surg Engl. 2007;89:0–3. doi: 10.1308/147870807X227818 DOI: https://doi.org/10.1308/147870807X227818
Clinical presentation of acute appendicitis in adults at the Chris Hani Baragwanath academic hospital. Nshuti R, Kruger D, Luvhengo TE. Int J Emerg Med. 2014;7:12. doi: 10.1186/1865-1380-7-12. DOI: https://doi.org/10.1186/1865-1380-7-12
Diagnosis and management of acute appendicitis in adults: a review. Moris D, Paulson EK, Pappas TN. JAMA. 2021;326:2299–2311. doi: 10.1001/jama.2021.20502. DOI: https://doi.org/10.1001/jama.2021.20502
Appendicitis in the elderly: what has changed? Rub R, Margel D, Soffer D, Kluger Y. https://pubmed.ncbi.nlm.nih.gov/10774271/ Isr Med Assoc J. 2000;2:220–223.
Scoring systems in the diagnosis of acute appendicitis in the elderly. Konan A, Hayran M, Kılıç YA, Karakoç D, Kaynaroğlu V. Ulus Travma Acil Cerrahi Derg. Sep. 2011;17:396–400. DOI: https://doi.org/10.5505/tjtes.2011.03780
Acute appendicitis in pregnancy: literature review. Franca Neto AH, Amorim MM, Nóbrega BM. Rev Assoc Med Bras (1992) 2015;61:170–177. doi: 10.1590/1806-9282.61.02.170. DOI: https://doi.org/10.1590/1806-9282.61.02.170
A useful sign for the diagnosis of peritoneal irritation in the right iliac fossa and can serum interleukin-6 levels predict the outcome of patients with right iliac fossa pain? Davenport M. https://pubmed.ncbi.nlm.nih.gov/9244086/ Ann R Coll Surg Engl. 1997;79:310–311.
Left-sided acute appendicitis: a pitfall in the emergency department. Yang CY, Liu HY, Lin HL, Lin JN. J Emerg Med. Dec. 2012;43:980–982. doi: 10.1016/j.jemermed.2010.11.056. DOI: https://doi.org/10.1016/j.jemermed.2010.11.056
Acute infectious diarrhea in children. Koletzko S, Osterrieder S. Dtsch Arztebl Int. 2009;106:539–547. doi: 10.3238/arztebl.2009.0539. DOI: https://doi.org/10.3238/arztebl.2009.0539
An unusually long appendix in a child: a case report. Alzaraa A, Chaudhry S. Cases J Jun. 2009;2:7398. doi: 10.4076/1757-1626-2-7398. DOI: https://doi.org/10.4076/1757-1626-2-7398
Acute appendicitis masquerading as acute scrotum: a case report. Dienye PO, Jebbin NJ. Am J Mens Health. 2011;5:524–527. doi: 10.1177/1557988311415514. DOI: https://doi.org/10.1177/1557988311415514
Appendicitis in strangulated femoral hernia: a case report. Rebai W, Hentati H, Makni A, et al. https://pubmed.ncbi.nlm.nih.gov/20415194/ Tunis Med. 2010;88:193–195.
Atypical appendicitis in the elderly. Gaisinskaya P, VanHelmond T, Hernandez OL. Cureus. Feb. 2022;14:0. doi: 10.7759/cureus.22495. DOI: https://doi.org/10.7759/cureus.22495
Acute appendicitis in childhood and adulthood. Téoule P, Laffolie J, Rolle U, Reissfelder C. Dtsch Arztebl Int. 2020;117:764–774. doi: 10.3238/arztebl.2020.0764. DOI: https://doi.org/10.3238/arztebl.2020.0764
Appendicitis in pregnancy: new information that contradicts long-held clinical beliefs. Mourad J, Elliott JP, Erickson L, Lisboa L. Am J Obstet Gynecol. 2000;182:1027–1029. doi: 10.1067/mob.2000.105396. DOI: https://doi.org/10.1067/mob.2000.105396
Risk of acute appendicitis in and around pregnancy: a population-based cohort study from England. Zingone F, Sultan AA, Humes DJ, West J. Ann Surg. 2015;261:332–337. doi: 10.1097/SLA.0000000000000780. DOI: https://doi.org/10.1097/SLA.0000000000000780
Obstructive uropathy secondary to missed acute appendicitis. Gachabayov M. Case Rep Surg. 2016;2016:4641974. doi: 10.1155/2016/4641974. DOI: https://doi.org/10.1155/2016/4641974
Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. Di Saverio S, Podda M, De Simone B, et al. World J Emerg Surg. 2020;15:27. doi: 10.1186/s13017-020-00306-3. DOI: https://doi.org/10.1186/s13017-020-00306-3
Diagnosis of uncomplicated and complicated appendicitis in adults. Bom WJ, Scheijmans JCG, Salminen P, Boermeester MA. Scand J Surg. 2021;110:170–179. doi: 10.1177/14574969211008330. DOI: https://doi.org/10.1177/14574969211008330
Is “pain before vomiting” useful?: diagnostic performance of the classic patient history item in acute appendicitis. Takada T, Inokuchi R, Kim H, et al. https://doi.org/10.1016/j.ajem.2020.12.066. Am J Emerg Med. 2021;41:84–89. doi: 10.1016/j.ajem.2020.12.066. DOI: https://doi.org/10.1016/j.ajem.2020.12.066
Single and combined diagnostic value of clinical features and laboratory tests in acute appendicitis. Laméris W, Van Randen A, Go PMNYH, et al. Acad Emerg Med. 2009;16:835–842. doi: 10.1111/j.1553-2712.2009.00486.x. DOI: https://doi.org/10.1111/j.1553-2712.2009.00486.x
Diagnostic accuracy of combined WBC, ANC and CRP in adult emergency department patients suspected of acute appendicitis. Huckins DS, Copeland K. Am J Emerg Med. 2021;44:401–406. doi: 10.1016/j.ajem.2020.04.086 DOI: https://doi.org/10.1016/j.ajem.2020.04.086
Diagnostic performance of a biomarker panel as a negative predictor for acute appendicitis in adult ED patients with abdominal pain. Huckins DS, Copeland K, Self W, et al. Am J Emerg Med Mar. 2017;35:418–424. doi: 10.1016/j.ajem.2016.11.027. DOI: https://doi.org/10.1016/j.ajem.2016.11.027
Usefulness of new and traditional serum biomarkers in children with suspected appendicitis. Benito J, Acedo Y, Medrano L, Barcena E, Garay RP, Arri EA. Am J Emerg Med. 2016;34:871–876. doi: 10.1016/j.ajem.2016.02.011. DOI: https://doi.org/10.1016/j.ajem.2016.02.011
Evaluation of the diagnostic accuracy of plasma markers for early diagnosis in patients suspected for acute appendicitis. Schellekens DHSM, Hulsewé KWE, van Acker BAC, et al. Acad Emerg Med. 2013;20:703–710. doi: 10.1111/acem.12160. DOI: https://doi.org/10.1111/acem.12160
Hyperbilirubinemia as a predictor of severity of acute appendicitis. Akai M, Iwakawa K, Yasui Y, et al. J Int Med Res. 2019;47:3663–3669. doi: 10.1177/0300060519856155. DOI: https://doi.org/10.1177/0300060519856155
Hyperbilirubinemia and Hyponatremia as Predictors of Complicated Appendicitis. Shuaib A, Alhamdan N, Arian H, Sallam MA, Shuaib A. Medical Sciences. 2022;10:36. doi: 10.3390/medsci10030036. DOI: https://doi.org/10.3390/medsci10030036
Delta neutrophil index: a reliable marker to differentiate perforated appendicitis from non-perforated appendicitis in the elderly. Shin DH, Cho YS, Kim YS, et al. J Clin Lab Anal. 2018;32 doi: 10.1002/jcla.22177. DOI: https://doi.org/10.1002/jcla.22177
How to diagnose an acutely inflamed appendix; a systematic review of the latest evidence. Kabir SA, Kabir SI, Sun R, Jafferbhoy S, Karim A. https://doi.org/10.1016/j.ijsu.2017.03.013. Int J Surg. 2017;40:155–162. doi: 10.1016/j.ijsu.2017.03.013. DOI: https://doi.org/10.1016/j.ijsu.2017.03.013
Sonography and computed tomography in diagnosing acute appendicitis. Hwang ME. https://pubmed.ncbi.nlm.nih.gov/29298941/ Radiol Technol. 2018;89:224–237.
Diagnosing acute appendicitis: surgery or imaging? van Rossem CC, Bolmers MDM, Schreinemacher MHF, et al. https://doi.org/10.1111/codi.13470. Colorectal Dis. 2016;18:1129–1132. doi: 10.1111/codi.13470. DOI: https://doi.org/10.1111/codi.13470
Acute appendicitis: Meta-analysis of diagnostic performance of CT and graded compression US related to prevalence of disease. Randen Av, Bipat S, Zwinderman AH, Ubbink DT, Stoker J, Boermeester MA. Radiology. 2008;249:97–106. doi: 10.1148/radiol.2483071652. DOI: https://doi.org/10.1148/radiol.2483071652
A systematic review and meta-analysis of diagnostic performance of MRI for evaluation of acute appendicitis. Duke E, Kalb B, Arif-Tiwari H, et al. AJR Am J Roentgenol. 2016;206:508–517. doi: 10.2214/AJR.15.14544. DOI: https://doi.org/10.2214/AJR.15.14544
Pregnancy and appendicitis: a systematic review and meta-analysis on the clinical use of MRI in diagnosis of appendicitis in pregnant women. Kave M, Parooie F, Salarzaei M. World J Emerg Surg. 2019;14:37. doi: 10.1186/s13017-019-0254-1. DOI: https://doi.org/10.1186/s13017-019-0254-1
Diagnostic value of laparoscopy, abdominal computed tomography, and ultrasonography in acute appendicitis. Bachar I, Perry ZH, Dukhno L, Mizrahi S, Kirshtein B. J Laparoendosc Adv Surg Tech A. 2013;23:982–989. doi: 10.1089/lap.2013.0035. DOI: https://doi.org/10.1089/lap.2013.0035
Laboratory markers used in the prediction of perforation in acute appendicitis. Patmano M, Çetin DA, Gümüş T. Ulus Travma Acil Cerrahi Derg. 2022;28:960–966. doi: 10.14744/tjtes.2021.83364. DOI: https://doi.org/10.14744/tjtes.2021.83364
The role of neutrophil-lymphocyte-ratio (NLR) and platelet-lymphocyte-ratio (PLR) as a biomarker for distinguishing between complicated and uncomplicated appendicitis. Rajalingam VR, Mustafa A, Ayeni A, et al. Cureus. 2022;14:0. doi: 10.7759/cureus.21446. DOI: https://doi.org/10.7759/cureus.21446
Predictive factors for negative outcomes in initial non-operative management of suspected appendicitis. Shindoh J, Niwa H, Kawai K, et al. J Gastrointest Surg. 2010;14:309–314. doi: 10.1007/s11605-009-1094-1. [ DOI: https://doi.org/10.1007/s11605-009-1094-1
A model to select patients who may benefit from antibiotic therapy as the first line treatment of acute appendicitis at high probability. Hansson J, Khorram-Manesh A, Alwindawe A, Lundholm K. J Gastrointest Surg. 2014;18:961–967. doi: 10.1007/s11605-013-2413-0. DOI: https://doi.org/10.1007/s11605-013-2413-0
Surgery for appendicitis: is it necessary? Mason RJ. Surg Infect (Larchmt) 2008;9:481–488. doi: 10.1089/sur.2007.079. DOI: https://doi.org/10.1089/sur.2007.079
Appendicitis and the antibiotics. Harrison PW. Am J Surg. 1953;85:160–163. doi: 10.1016/0002-9610(53)90476-0. DOI: https://doi.org/10.1016/0002-9610(53)90476-0
Treatment of acute appendicitis. Coldrey E. Br Med J. 1956;2:1458–1461. doi: 10.1136/bmj.2.5007.1458. DOI: https://doi.org/10.1136/bmj.2.5007.1458
The Nota study (non operative treatment for acute appendicitis): prospective study on the efficacy and safety of antibiotics (amoxicillin and clavulanic acid) for treating patients with right lower quadrant abdominal pain and long-term follow-up of conservatively treated suspected appendicitis. Di Saverio S, Sibilio A, Giorgini E, et al. Ann Surg. 2014;260:109–117. doi: 10.1097/SLA.0000000000000560. DOI: https://doi.org/10.1097/SLA.0000000000000560
Antibiotic therapy vs appendectomy for treatment of uncomplicated acute appendicitis: the APPAC randomized clinical trial. Salminen P, Paajanen H, Rautio T, et al. JAMA. 2015;313:2340–2348. doi: 10.1001/jama.2015.6154. DOI: https://doi.org/10.1001/jama.2015.6154
Five-year follow-up of antibiotic therapy for uncomplicated acute appendicitis in the APPAC randomized clinical trial. Salminen P, Tuominen R, Paajanen H, et al. Jama. 2018;320:1259–1265. doi: 10.1001/jama.2018.13201. DOI: https://doi.org/10.1001/jama.2018.13201
Appendectomy versus conservative treatment with antibiotics for patients with uncomplicated acute appendicitis: a propensity score-matched analysis of patient-centered outcomes (the ACTUAA prospective multicenter trial) Podda M, Poillucci G, Pacella D, et al. Int J Colorectal Dis. 2021;36:589–598. doi: 10.1007/s00384-021-03843-8. DOI: https://doi.org/10.1007/s00384-021-03843-8
Meta-analysis of antibiotics versus appendicectomy for non-perforated acute appendicitis. Sallinen V, Akl EA, You JJ, et al. Br J Surg. 2016;103:656–667. doi: 10.1002/bjs.10147. DOI: https://doi.org/10.1002/bjs.10147
Operative versus non-operative management in the care of patients with complicated appendicitis. Helling TS, Soltys DF, Seals S. Am J Surg. 2017;214:1195–1200. doi: 10.1016/j.amjsurg.2017.07.039. DOI: https://doi.org/10.1016/j.amjsurg.2017.07.039
Complicated appendicitis: Immediate operation or trial of nonoperative management? Nimmagadda N, Matsushima K, Piccinini A, et al. Am J Surg. 2019;217:713–717. doi: 10.1016/j.amjsurg.2018.12.061. DOI: https://doi.org/10.1016/j.amjsurg.2018.12.061
WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. Di Saverio S, Birindelli A, Kelly MD, et al. World J Emerg Surg. 2016;11:34. doi: 10.1186/s13017-016-0090-5. DOI: https://doi.org/10.1186/s13017-016-0090-5
Diagnosis and management of acute appendicitis. EAES consensus development conference 2015. Gorter RR, Eker HH, Gorter-Stam MA, et al. Surg Endosc. 2016;30:4668–4690. doi: 10.1007/s00464-016-5245-7. DOI: https://doi.org/10.1007/s00464-016-5245-7
Randomized clinical trials comparing antibiotic therapy with appendicectomy for uncomplicated acute appendicitis: meta-analysis. Herrod PJJ, Kwok AT, Lobo DN. BJS Open. 2022;4 doi: 10.1093/bjsopen/zrac100. DOI: https://doi.org/10.1093/bjsopen/zrac100
A randomized trial comparing antibiotics with appendectomy for appendicitis. The CODA Collaborative. NEJM. 2020;383:1907–1919. doi: 10.1056/NEJMoa2014320. DOI: https://doi.org/10.1056/NEJMoa2014320
A randomized clinical trial evaluating the efficacy and quality of life of antibiotic-only treatment of acute uncomplicated appendicitis: results of the COMMA trial. O'Leary DP, Walsh SM, Bolger J, et al. Ann Surg. 2021;274:240–247. doi: 10.1097/SLA.0000000000004785. DOI: https://doi.org/10.1097/SLA.0000000000004785
Optimal initial antibiotic regimen for the treatment of acute appendicitis: a systematic review and network meta-analysis with surgical intervention as the common comparator. Wang CH, Yang CC, Hsu WT, et al. J Antimicrob Chemother. 2021;76:18–2021. doi: 10.1093/jac/dkab074. DOI: https://doi.org/10.1093/jac/dkab074
Abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis. Cheng Y, Zhou S, Zhou R, et al. Cochrane Database Syst Rev. 2015;2 doi: 10.1002/14651858.CD010168.pub2. DOI: https://doi.org/10.1002/14651858.CD010168.pub2
Initial nonoperative management for periappendiceal abscess. Oliak D, Yamini D, Udani VM, et al. Dis Colon Rectum Jul. 2001;44:936–941. doi: 10.1007/BF02235479. DOI: https://doi.org/10.1007/BF02235479
Appendiceal abscess: immediate operation or percutaneous drainage? Brown CV, Abrishami M, Muller M, Velmahos GC. https://pubmed.ncbi.nlm.nih.gov/14570357/ Am Surg. 2003;69:829–832. DOI: https://doi.org/10.1177/000313480306901002
Is there truly an oncologic indication for interval appendectomy? Wright GP, Mater ME, Carroll JT, Choy JS, Chung MH. Am J Surg. 2015;209:442–446. doi: 10.1016/j.amjsurg.2014.09.020. DOI: https://doi.org/10.1016/j.amjsurg.2014.09.020
Increased risk of neoplasm in appendicitis treated with interval appendectomy: single-institution experience and literature review. Carpenter SG, Chapital AB, Merritt MV, Johnson DJ. https://pubmed.ncbi.nlm.nih.gov/22524774/ Am Surg. 2012;78:339–343. DOI: https://doi.org/10.1177/000313481207800344
Charles Heber McBurney (1845 - 1913) Yale SH, Musana KA. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1237161/ Clin Med Res. 2005;3:187–189. DOI: https://doi.org/10.3121/cmr.3.3.187
The indications for early laparotomy in appendicitis. McBurney C. Ann Surg. 1891;13:233–254. doi: 10.1097/00000658-189101000-00061. DOI: https://doi.org/10.1097/00000658-189101000-00061
The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating. McBurney C. Ann Surg. 1894;20:38–43. doi: 10.1097/00000658-189407000-00004 DOI: https://doi.org/10.1097/00000658-189407000-00004
Published
How to Cite
Issue
Section
Copyright (c) 2023 International journal of health sciences

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.








