Acute appendicitis

Your progress

Saved on this device.

Target exams

Red flags

• A perforated appendix carries a mortality around 5 per cent against under 0.1 per cent for non-gangrenous disease — the window to operate is short and the septic patient needs the simultaneous resuscitation and the theatre
• Every woman of reproductive age with right iliac fossa pain has an ectopic pregnancy and a torsion until the beta-hCG and the ultrasound exclude them
• The elderly, the diabetic, the immunosuppressed and the pregnant patient frequently present with atypical or muted pain — the diagnosis is missed and the perforation is more common
• The appendiceal mass or abscess in the delayed presentation is often managed conservatively with the antibiotics and the interval appendicectomy, not the immediate surgery
• A normal WCC and CRP together make appendicitis unlikely — but an inflamed appendix on imaging with compatible pain is appendicitis regardless of the bloods