Diagnosis and management of complicated appendicitis: literature review

 Akvilė Bumblytė1

1Faculty of Medicine, Vilnius University, Vilnius, Lithuania


Acute appendicitis is one of the most frequent surgical diseases of the abdominal cavity. Complicated appendicitis is diagnosed in approximately thirty percent of all cases. Complicated appendicitis is described as gangrenous appendix with perforation and generalized or local peritonitis or with abscess of the abdominal cavity, usually in the right iliac space. Computer tomography plays a significant role in diagnosing complicated appendicitis. Management of appendix mass is still controversial due to the lack of high-level evidence. A great majority of recent evidence supports a conservative management approach avoiding urgent appendectomy because of the high risk of major complications. Urgent appendectomy is recommended in the presence of complicated appendicitis and generalized peritonitis. Routine interval appendectomy should be considered in the context of recurrent appendicitis.

Aim: to analyze diagnostics and management of complicated appendicitis reviewed in literature.

Methods: “Pubmed“ database was chosen as the source of literature. Specific keywords such as “complicated appendicitis”, “perforated appendicitis”, “appendix abscess”, “appendix mass”, “periappendicular abscess”, “phlegmon” were used to find relevant information. No time restriction was applied to citations.

Keywords: complicated appendicitis, perforated appendicitis, appendix abscess, appendix mass, periappendicular abscess, phlegmon.