Acute appendicitis

Acute appendicitis is the most common abdominal surgical emergency. Careful history taking and focused physical examination are essential for accurate diagnosis. CT scan has become a routine adjunct in the work - up and is particularly helpful in female patients and in patients with atypical presentation. Prompt operative management with perioperative antibiotic prophylaxis is the mainstay of treatment. Open and laparoscopic appendectomy are associated with low morbidity and mortality. The laparoscopic approach is associated with lower wound infection rate and shorter hospital stays despite longer operative time and higher costs. Delay in presentation, diagnosis, or treatment of acute appendicitis is associated with increased risk of perforation resulting in higher infectious complications. Patients presenting with perforated appendicitis with a phlegmon or abscess can be managed with immediate appendectomy or non - operatively with antibiotics, bowel rest, and percutaneous drainage, followed by either expectant management or interval appendectomy. Although immediate appendectomy is feasible, it can be technically challenging and is associated with a higher incidence of complications than conservative management.