Acute Appendicitis

Key points

• Acute appendicitis is the most common acute abdominal condition requiring surgery. It can occur at any age but is most common in young people aged 10-20 years. Abdominal pain is seen in the vast majority of patients:
• peri-umbilical abdominal pain (visceral stretching of appendix lumen and appendix is midgut structure) radiating to the right iliac fossa (RIF) due to localised parietal peritoneal inflammation.
• the migration of the pain from the centre to the RIF has been shown to be one of the strongest indicators of appendicitis
• patients often report the pain being worse on coughing or going over speed bumps. Children typically can't hop on the right leg due to the pain. Other features:
• vomit once or twice but marked and persistent vomiting is unusual