Acute Appendicitis

What is acute appendicitis?

Acute appendicitis is inflammation of the appendix that occurs after luminal obstruction, and it is one of the most common causes of acute abdominopelvic pain. Patients commonly present with right lower quadrant pain and tenderness, nausea, vomiting, fever, and leukocytosis.

Early and accurate diagnosis with CT or MRI helps to minimize morbidity and mortality owing to appendiceal perforation and prevents unnecessary surgery for nonsurgical conditions that may mimic the clinical presentation of appendicitis. MRI is most often utilized when acute appendicitis is suspected in the setting of pregnancy.

7 Interesting Facts of Acute Appendicitis

  1. Calculus positioned in distal right ureter can mimic location and severity of abdominal pain found in acute appendicitis
  2. Differentiate with:
    • Urinalysis: hematuria found in approximately 80% of nephrolithiasis; not typically found in appendicitis
    • Noncontrast CT of abdomen and pelvis 
      • Hydroureteronephrosis is visible to the level of an obstructing stone in nephrolithiasis
      • Shows distended appendix and inflammation of periappendicular fat in appendicitis

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