appendicitis

Appendicitis is an inflammation of the appendix, a narrow pouch attached to the beginning of the large intestine. It is one of the most common causes of acute abdominal pain requiring surgery. It occurs across ages but is most common in late adolescence and early adulthood. In developed countries, the lifetime risk is about 7 to 8 percent.

Symptoms typically begin with periumbilical pain that localizes to the right lower quadrant within 12 to 24 hours, often accompanied by loss of appetite, nausea, vomiting, and a low-grade fever. Physical examination may reveal tenderness at McBurney's point, rebound tenderness, and guarding. White blood cell count is often elevated with neutrophilia. The presentation can vary, and young children, older adults, and pregnant people may have atypical signs.

Diagnosis relies on clinical assessment supplemented by tests. Blood tests commonly show leukocytosis with neutrophilia. Imaging is used to confirm the diagnosis and rule out other conditions: ultrasound is preferred in children and pregnant patients; CT scan is commonly used in adults; MRI may be used during pregnancy.

Management usually involves urgent surgical removal of the appendix (appendectomy). Laparoscopic appendectomy is the most common approach; open surgery is chosen in certain situations. In select cases of uncomplicated appendicitis, antibiotic therapy alone may be considered, but surgery remains the standard treatment in most settings to prevent recurrence and complications.

Prognosis is generally favorable with timely treatment. Delay increases the risk of perforation, peritonitis, and longer hospitalization. Prevention of appendicitis has not been established; no proven method reliably reduces risk.