RT Book, Section
A1 DeKoning, E. Paul
A2 Tintinalli, Judith E.
A2 Stapczynski, J. Stephan
A2 Ma, O. John
A2 Yealy, Donald M.
A2 Meckler, Garth D.
A2 Cline, David M.
SR Print(0)
ID 1121505880
T1 Acute Appendicitis
T2 Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9780071794763
LK accessmedicine.mhmedical.com/content.aspx?aid=1121505880
RD 2024/04/19
AB Between  250,000  and  300,000  appendectomies  for  acute  appendicitis  are  performed  each  year  in  the  United  States,1  with  an  additional  700,000  patients  affected  in  the  European  community.2  The  lifetime  risk  of  acute  appendicitis  in  the  United  States  is  an  estimated  12%  for  males  and  25%  for  females.3  Yet,  the  epidemiology  of  this  common  ED  diagnosis  continues  to  change.  Data  suggest  a  reversal  of  a  previous  decline  in  incidence,  with  the  annual  rate  increasing  from  7.62  to  9.38  per  10,000  between  1993  and  2008,4  whereas  the  rate  of  negative  appendectomy  has  declined.5  Similarly,  between  2001  and  2008  the  rate  of  perforation  decreased,  but  this  declining  trend  has  not  been  consistent.4,6  Acute  appendicitis  is  most  common  in  patients  aged  10  to  19  years,4  remains  the  most  frequent  cause  of  atraumatic  abdominal  pain  in  children  >1  year  old,7  and  is  the  most  common  nonobstetric  surgical  emergency  in  pregnancy,  complicating  up  to  1  in  1500  pregnancies.8,9  Despite  advances  in  lab  testing  and  imaging,  accurate  diagnosis  is  a  challenge.  Both  "missed  appendicitis"  and  unnecessary  surgery  for  a  false  diagnosis  are  not  without  consequence.  Thus,  consider  appendicitis  in  any  patient  with  acute  atraumatic  abdominal  pain  without  prior  appendectomy.