1Simona Ripkauskaitė, 1Martyna Bakutytė, 1Vilius Ripkauskas
1Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania
Appendicitis is an acute inflammation of the vermiform appendix that is often associated with obstruction and develops as a result of a pathogenic intestinal microflora. Acute appendicitis is a common disease, mainly developing during second or third decade of life. The lifetime risk for acute appendicitis is 8,6 % in men and 6,7 % in women. Accordingly, appendectomy is one of the most common surgical procedures in the world. Over 300,000 appendectomies are performed annually in the United States. The inflammation is usually polymicrobial, frequently including both aerobic and anaerobic gram-negative bacteries. Mesenteric adenitis caused by Yersinia spp., cytomegalovirus, Epstein-Barr or adenoviruses can often mimic appendicitis. Diagnosing appendicitis is more difficult in pregnant women in whom gynecological processes can also mimic appendicitis. Clinical diagnosis is enhanced by the use of imaging, especially computed tomography and abdominal ultrasound. Laparoscopic appendicectomy is becoming increasingly common, and clinical evidence suggests that it has some advantages over open surgery. When prescribing antibacterial therapy it is important to choose broad coverage antibiotics, taking into account pathogens that usually persist in the intestines. It has been proven that acute appendicitis can be successfully treated without surgery, which could help prevent postoperative adhesive disease. This article reviews the clinical signs, diagnosis and treatment of acute appendicitis.
Keywords: acute appendicitis, infection, inflammation of the vermiform appendix.