Appendicitis natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
If left untreated, appendicitis can lead to death if [[peritonitis]] develops from the rupturing of the [[appendix]]. Acute appendicitis that is evaluated and treated early with an [[appendectomy]] generally leads to no further complications and to a full recovery of the patient.
Appendicitis can lead to death if [[peritonitis]] develops from the rupturing of the [[appendix]] and is left untreated. Acute appendicitis that is evaluated and treated early with an [[appendectomy]] generally leads to no further complications and a patient's full recovery.


==Natural History==
==Natural History==
The symptoms of Appendicitis typically develop acutely after the [[inflammation]] of the [[appendix]]. Without treatment, the patient will likely develop symptoms of [[pain]] starting centrally (periumbilical) before localizing to the [[right iliac fossa]]loss of appetite, [[diarrhea]], [[fever]], [[nausea]], and [[vomiting]] which may eventually lead to death if [[peritonitis]] occurs due to appendiceal bursting.
*The symptoms of appendicitis typically develop shortly after [[inflammation]] of the [[appendix]].  
*Without treatment, the patient will likely develop symptoms of [[pain]], starting centrally (in the periumbilical region) before localizing to the [[right iliac fossa]] in the right lower quadrant of the [[abdomen]].
**They will also experience [[loss of appetite]], [[diarrhea]], [[fever]], [[nausea]], and [[vomiting]]
**During the final stage of the untreated disease process, the appendix will rupture, and this may eventually lead to death if [[peritonitis]] develops.<ref> Appendicitis. Wikipedia (2016). http://schools-wikipedia.org/wp/a/Appendicitis.htm Accessed on February 4, 2016</ref>


==Complications==
==Complications==
In cases of acute appendicitis, life-threatening [[peritonitis]] can occur if the appendix bursts.  It is for this reason that appendicitis cases are evaluated and treated speedily.
Most complications that can develop as a result of the treatment of appendicitis include:<ref name="wiki1"> Appendicitis. Wikipedia (2016). http://schools-wikipedia.org/wp/a/Appendicitis.htm Accessed on February 4, 2016</ref>
*Abnormal connections between abdominal organs or between these organs and the skin surface ([[fistula]])
*[[Appendicular abscess|Abscess]]
*[[Rupture]]
*Infection of the surgical wound
*[[Peritonitis (patient information)|Peritonitis]]


==Prognosis==
==Prognosis==
* Most appendicitis patients recover easily with treatment, but complications can occur if treatment is delayed or if [[peritonitis]] occurs.
* Most patients with appendicitis recover quickly with surgical treatment ([[laparoscopic]] [[appendectomy]]), but complications can occur if treatment is delayed or if [[peritonitis]] occurs.
* Recovery time depends on age, condition, complications, and other circumstances, including the amount of alcohol consumption, but usually is between 10 and 28 days. For young children (around 10 years old) the recovery takes three weeks.
* Recovery time depends on age, condition, complications, and other aspects in the patient's history (including amount of alcohol consumption).
**It usually takes between 10 and 28 days to recover completely.  
*For young children (around 10 years old), recovery takes three weeks.
* Typical acute appendicitis responds quickly to [[appendectomy]] and occasionally will resolve spontaneously.
* Typical acute appendicitis responds quickly to [[appendectomy]] and occasionally will resolve spontaneously.
** If appendicitis resolves spontaneously, it remains controversial whether an elective interval appendectomy should be performed to prevent a recurrent episode of appendicitis.
** If appendicitis resolves spontaneously, it remains controversial whether an elective interval appendectomy should be performed to prevent a recurrent episode of appendicitis.
* Atypical appendicitis (associated with [[suppuration|suppurative]] appendicitis) is more difficult to diagnose and is more apt to be complicated even when operated early.
* Atypical appendicitis (associated with [[suppuration|suppurative]] appendicitis) is more difficult to diagnose and is more apt to be complicated, even when operated on early.
** In either condition prompt diagnosis and appendectomy yield the best results with full recovery in two to four weeks usually.
** In either condition, prompt diagnosis and appendectomy yield the best results with full recovery usually occurring in two to four weeks.
* Mortality and severe complications are unusual but do occur in cases of appendicitis, especially if peritonitis persists and is untreated
*Mortality and severe complications are unusual but do occur in some cases of appendicitis, especially if peritonitis develops and is left untreated.<ref name="wiki1"> Appendicitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Appendicitis#Clinical Accessed on February 4, 2016</ref>
 
==References==
{{Reflist|2}}
{{WH}}
{{WS}}
 
[[Category:Emergency medicine]]
[[Category:Surgery]]
[[Category:Gastroenterology]]

Latest revision as of 20:27, 29 July 2020

Appendicitis Microchapters

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Risk calculators and risk factors for Appendicitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farwa Haideri [2]

Overview

Appendicitis can lead to death if peritonitis develops from the rupturing of the appendix and is left untreated. Acute appendicitis that is evaluated and treated early with an appendectomy generally leads to no further complications and a patient's full recovery.

Natural History

  • The symptoms of appendicitis typically develop shortly after inflammation of the appendix.
  • Without treatment, the patient will likely develop symptoms of pain, starting centrally (in the periumbilical region) before localizing to the right iliac fossa in the right lower quadrant of the abdomen.

Complications

Most complications that can develop as a result of the treatment of appendicitis include:[2]

  • Abnormal connections between abdominal organs or between these organs and the skin surface (fistula)
  • Abscess
  • Rupture
  • Infection of the surgical wound
  • Peritonitis

Prognosis

  • Most patients with appendicitis recover quickly with surgical treatment (laparoscopic appendectomy), but complications can occur if treatment is delayed or if peritonitis occurs.
  • Recovery time depends on age, condition, complications, and other aspects in the patient's history (including amount of alcohol consumption).
    • It usually takes between 10 and 28 days to recover completely.
  • For young children (around 10 years old), recovery takes three weeks.
  • Typical acute appendicitis responds quickly to appendectomy and occasionally will resolve spontaneously.
    • If appendicitis resolves spontaneously, it remains controversial whether an elective interval appendectomy should be performed to prevent a recurrent episode of appendicitis.
  • Atypical appendicitis (associated with suppurative appendicitis) is more difficult to diagnose and is more apt to be complicated, even when operated on early.
    • In either condition, prompt diagnosis and appendectomy yield the best results with full recovery usually occurring in two to four weeks.
  • Mortality and severe complications are unusual but do occur in some cases of appendicitis, especially if peritonitis develops and is left untreated.[2]

References

  1. Appendicitis. Wikipedia (2016). http://schools-wikipedia.org/wp/a/Appendicitis.htm Accessed on February 4, 2016
  2. 2.0 2.1 Appendicitis. Wikipedia (2016). http://schools-wikipedia.org/wp/a/Appendicitis.htm Accessed on February 4, 2016

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