B5. Acute appendicitis

Page created on September 11, 2021. Last updated on April 11, 2022 at 10:52


For etiology and pathomechanism, see the corresponding pathology 2 topic. For clinical features, and diagnosis and evaluation, see the corresponding internal medicine topic (62).


Immediate laparoscopic appendectomy is the gold standard for management of acute appendicitis. In case of perforated appendicitis, the patient may proceed directly to surgery as usual, or surgery may be postponed temporarily while the patient receives antibiotics and percutaneous drainage. Laparoscopic appendectomy is a relatively simple surgical procedure and is most surgeons’ first surgical procedure. It’s sometimes said that that the function of the appendix in the modern times is to allow young surgeons to improve their surgical technique.

Studies have shown that antibiotic therapy can be as effective as surgery for managing the initial presentation of appendicitis. However, these studies also conclude that this carries with it moderate risk of recurrence and missed neoplasms. As such, surgery remains the first choice.

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