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Appendicitis develops most commonly in the second trimester. [2] If appendicitis develops in a pregnant woman, an appendectomy is usually performed and should not harm the fetus. [15] The risk of premature delivery is about 10%. [16] The risk of fetal death in the perioperative period after an appendectomy for early acute appendicitis is 3 to 5%.
Most people with appendicitis recover quickly after surgical treatment, but complications can occur if treatment is delayed or if peritonitis occurs. Recovery time depends on age, condition, complications, and other circumstances, including the amount of alcohol consumption, but usually is between 10 and 28 days.
Amyand's hernia is a rare form of an inguinal hernia (less than 1% of inguinal hernias) [2] which occurs when the appendix is included in the hernial sac and becomes incarcerated. The condition is an eponymous disease named after a French surgeon, Claudius Amyand (1660–1740), [3] who performed the first successful appendectomy in 1735. [4]
Common causes of an acute abdomen include a gastrointestinal perforation, peptic ulcer disease, mesenteric ischemia, acute cholecystitis, appendicitis, diverticulitis, pancreatitis, and an abdominal hemorrhage. However, this is a non-exhaustative list and other less common causes may also lead to an acute abdomen. [3]
The sign indicates aggravation of the parietal peritoneum by stretching or moving. Positive Blumberg's sign is indicative of peritonitis, [3] which can occur in diseases like appendicitis, and may occur in ulcerative colitis with rebound tenderness in the right lower quadrant.
The symptoms may mimic those of acute appendicitis, diverticulitis, or cholecystitis. The pain is characteristically intense during/after defecation or micturition (espec. in the sigmoid type) due to the effect of traction on the pedicle of the lesion caused by straining and emptying of the bowel and bladder. Initial lab studies are usually normal.
It is also called appendicolith when it occurs in the appendix and is sometimes concurrent with appendicitis. [1] They can also obstruct diverticula. It can form secondary to fecal impaction. A fecaloma is a more severe form of fecal impaction, and a hardened fecaloma may be considered a giant fecalith. The term is from the Greek líthos=stone. [2]
Alvarado scoring has largely been superseded as a clinical prediction tool by the Appendicitis Inflammatory Response score. [2] [3] [4] Also known by the mnemonic MANTRELS, the scale has 6 clinical items (3 signs and 3 symptoms) and 2 laboratory measurements, each given an additive point score, with a maximum of 10 points possible. [5]