Appendicitis Questions & Answers

Updated: Jul 23, 2018
  • Author: Sandy Craig, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Questions & Answers

Overview

What is appendicitis?

What are the signs and symptoms of appendicitis?

What are the features of abdominal pain in appendicitis?

Which physical findings suggest appendicitis?

What are the less common signs of appendicitis?

Which lab tests may be helpful in the diagnosis of appendicitis in patients with an atypical presentation?

Which CBC count findings suggest appendicitis in patients with atypical presentation?

What is the significance of C-reactive protein levels in appendicitis?

What is the role of urinary 5-HIAA levels in the diagnosis of appendicitis?

What is the role of CT scanning in the diagnosis of appendicitis?

What are the ACEP recommendations for use of ultrasonography in the diagnosis of appendicitis?

Which imaging studies may be useful for the diagnosis of appendicitis?

How is appendicitis managed in the emergency department (ED)?

How is appendicitis treated?

Which antibiotics may be used in the treatment of appendicitis and how are they administered?

What is appendicitis?

Can appendicitis be diagnosed based on signs and symptoms?

What is the disease course of untreated appendicitis?

What are the diagnostic and surgical goals concerning appendicitis in the emergency department (ED)?

What is the anatomy of the appendix?

How can intraoperative hemorrhages be avoided in appendicitis?

Where the appendix located?

How often do congenital appendiceal disorders occur?

What causes appendicitis?

What is the role of appendiceal obstruction in the pathogenesis of appendicitis?

What are the most common causes of appendicitis?

What is the role of fecaliths in the pathogenesis of appendicitis?

What are the less common causes of appendicitis?

What is the incidence of appendicitis in the US?

What is the global incidence of appendicitis?

Is appendicitis more common in males or females?

How does the incidence of appendicitis vary among age groups?

What is the complication rate of appendectomy?

What is the mortality rate associated with appendicitis?

What is the rate of appendiceal perforation in patients with appendicitis?

What factors are predictive of complicated appendicitis in children?

Presentation

Which factors lead to inconsistent clinical presentation of appendicitis?

What is the focus of the history in suspected appendicitis?

What is the most common symptom of appendicitis and how does it progress?

Why is gastroenterologic and genitourinary history needed in suspected appendicitis?

Where is the appendix positioned?

What physical findings suggest appendicitis?

In addition to the abdomen, what should be included in the physical exam of a patient with suspected appendicitis?

Which signs should be noted in patients with suspected acute appendicitis?

How useful is digital rectal exam (DRE) in the evaluation of suspected appendicitis?

How does pregnancy affect the clinical presentation of appendicitis?

What is computer-aided diagnosis for appendicitis?

How is the MANTRELS score used in the diagnosis of appendicitis?

How effective is the MANTRELS score in diagnosing appendicitis?

How are the stages of appendicitis?

What are the characteristics of the early stage of appendicitis?

What are the characteristics of the suppurative stage of appendicitis?

What are the characteristics of the gangrenous, perforated, phlegmonous, and spontaneously resolving stages of appendicitis?

What is the incidence of recurrent appendicitis?

How is chronic appendicitis defined?

DDX

How accurate is the diagnosis of acute appendicitis?

What are the classic symptoms of appendicitis?

Which disorders should be included in the differential diagnoses of appendicitis?

How often is appendicitis misdiagnosed in women and what are the most common misdiagnoses?

During pregnancy, how does appendectomy affect maternal or fetal health?

How is appendicitis differentiated from ectopic pregnancy?

How often is appendicitis misdiagnosed in children and what are the most common misdiagnoses?

What physical findings are more likely to be present in children with misdiagnosed appendicitis?

What is the incidence of appendicitis in patients older than 60 years?

What are the differential diagnoses for Appendicitis?

Workup

How is appendicitis diagnosed in patients lacking a classic clinical presentation?

What is the role of lab tests in the diagnosis of appendicitis?

Which WBC count and neutrophilia levels suggest appendicitis?

Is a CBC count useful in the diagnosis of appendicitis?

What is the role of C-reactive protein (CRP) in the diagnosis of appendicitis?

What C-reactive protein (CRP) levels are suggest appendicitis?

What is the sensitivity of C-reactive protein level (CRP) in the diagnosis of appendicitis?

How effective are WBC count and C-reactive protein (CRP) in ruling out the diagnosis of appendicitis?

Is a triple screen of WBC count, CRP level, and neutrophilia effective in diagnosing appendicitis?

What is the role of urinalysis in differentiating appendicitis from UTIs?

What urinalysis results suggest appendicitis?

Can urinary 5-hydroxyindoleacetic acid (U-5-HIAA) be used as an early marker of appendicitis?

How effective is CT scanning when evaluating atypical presentations of appendicitis?

What is the role of multidetector CT (MDCT) in the diagnosis of acute appendicitis?

Are CT scans beneficial in the diagnosis of appendicitis?

How is CT scanning used in the diagnosis of appendicitis?

What are the adverse effects of CT scans in the diagnosis of appendicitis?

How effective is a screening algorithm for pediatric patients with suspected appendicitis?

What is the role of ultrasonography in the diagnosis of appendicitis?

When is ultrasonography recommended in the workup of appendicitis by the ACEP?

Can ultrasonography be used to diagnose appendicitis in women of childbearing age?

Can ultrasonography be used to differentiate complicated from uncomplicated appendicitis?

What is the role of abdominal X-ray in the diagnosis of appendicitis?

What is the role of barium enema exam in the diagnosis of appendicitis?

What is the role of radionuclide scanning in the diagnosis of appendicitis?

What is the role of MRI in the diagnosis of appendicitis?

How effective is MRI compared with ultrasonography in the diagnosis of appendicitis?

How do the microscopic findings change from the early stages to the later stages of appendicitis?

Treatment

How is an appendiceal mass managed?

What is the role of antibiotic therapy in the treatment of acute appendicitis?

What is the goal of the emergency department (ED) clinician when evaluating abdominal pain?

What treatment should be given in the emergency department (ED) for suspected appendicitis?

When should analgesics and antiemetics be administered to patients with acute undifferentiated abdominal pain in the emergency department (ED)?

What test should be obtained for all women of childbearing age with suspected appendicitis?

When is nonsurgical treatment indicated in patients with appendicitis?

How effective is nonsurgical treatment in comparison to an appendectomy for appendicitis?

When are preoperative antibiotics indicated in the treatment of appendicitis?

When is an immediate (emergent) appendectomy indicated in the treatment of appendicitis?

What is the risk of an appendiceal rupture in appendicitis?

Is a laparoscopic appendectomy effective and when is it contraindicated in the treatment of appendicitis?

According to the SAGES guidelines, when is laparoscopic appendectomy the preferred approach in the treatment of appendicitis?

Which patients should undergo a laparoscopy to confirm the diagnosis of appendicitis?

What are the adverse effects of a laparoscopic appendectomy in the treatment of appendicitis?

What are the advantages and disadvantages of a laparoscopic appendectomy in the treatment of appendicitis?

What are the possible complications of appendicitis?

When should a general surgeon be consulted in the treatment of appendicitis?

Medications

What are the goals of therapy for appendicitis?

How effective are antibiotics in the treatment of appendicitis and what are the recommended regimens?

Which medications in the drug class Penicillins are used in the treatment of Appendicitis?

Which medications in the drug class Cephalosporins are used in the treatment of Appendicitis?

Which medications in the drug class Aminoglycosides are used in the treatment of Appendicitis?

Which medications in the drug class Carbapenems are used in the treatment of Appendicitis?

Which medications in the drug class Fluoroquinolones are used in the treatment of Appendicitis?

Which medications in the drug class Anti-infective Agents are used in the treatment of Appendicitis?

Which medications in the drug class Analgesics are used in the treatment of Appendicitis?