ACUTE APPENDICITIS

Key words: Acute appendicitis, Ultrasound, Alvarado score, Diagnosis

Acute appendicitis is caused by the obstruction of the lumen due to coprolytes, mucus, lymphoid hyperplasia. The earliest symptom is periumbilical pain accompanied by vomiting. Later the appendix gets infected, fever develops and the peritoneum gets involved. The pain becomes more localised. Diagnosis can be improved by clinical monitoring and imaging. The Alvarado score helps identifying children who should undergo ultrasound. Diagnostic sensitivity of ultrasound is very close to 100% with a specificity of 90%. Spiral CT scan reduces by 50% the number of unnecessary appendicectomies. 86% of patients can be discharged within 24 hours from surgery.