Appendicitis classification

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


Appendicitis may be classified based on based on the duration of symptoms, based on etiology of obstruction and based on whether appendix has been perforated or not.


Based on cause of Obstruction

Appendicitis may be classified based on the etiology of obstruction into:[1]

  • Infectious appendicitis - Obstruction of appendicial lumen is due to infectious inflammation[2].
  • Fibrosis appendicitis- Scar tissue from a previous surgery can lead to obstruction.
  • Fecaliths appendicitis - Hard fecal masses block the outlet of appendix
  • Neoplasic appendicitis - Carcinoid, adenocarcinoma, or mucocele is responsible for increased secretions resulting in blockage.
  • Parasitic appendicitis- In endemic areas obstruction of the appendicial lumen is due to parasitic load.
  • Calculic appendicitis
  • Lymphoid hyperplasic appendicitis Obstruction of lumen due cell hyperplasia.

Based on Perforation

Appendicitis may be classified based on perforations or non-perforations[3].

Perforating appendicitis

  • The appendiceal wall has been compromised due to pressure and inflammation and the intraluminal contents have leaked out into the peritoneal cavity.
  • Increases in incidence with age and is associated with the following types of bacterial infiltration:[4]

Non-perforating appendicitis

  • Inflammation is contained within the appendix; no intraluminal contents have leaked out.

Based on duration of symptoms

Appendicitis may be classified based on duration of symptoms into:

Acute appendicitis
  • Symptoms have existed less than 48 hours.

Non acute appendicitis

  •  Symptoms have existed for days or weeks, or have recurred several times.


  1. Yelon, Jay A. & Luchette, Fred A. (2014), Geriatric Trauma and Critical Care (1st ed.), New York, New York: Springer
  2. Gomes CA, Sartelli M, Di Saverio S, Ansaloni L, Catena F, Coccolini F, Inaba K, Demetriades D, Gomes FC, Gomes CC (2015). "Acute appendicitis: proposal of a new comprehensive grading system based on clinical, imaging and laparoscopic findings". World J Emerg Surg. 10: 60. doi:10.1186/s13017-015-0053-2. PMC 4669630. PMID 26640515.
  3. de Wijkerslooth E, van den Boom AL, Wijnhoven B (February 2019). "Variation in Classification and Postoperative Management of Complex Appendicitis: A European Survey". World J Surg. 43 (2): 439–446. doi:10.1007/s00268-018-4806-4. PMC 6329835. PMID 30255334. Vancouver style error: initials (help)
  4. Luckmann R (1989). "Incidence and case fatality rates for acute appendicitis in California. A population-based study of the effects of age". Am. J. Epidemiol. 129 (5): 905–18. PMID 2784936. Unknown parameter |month= ignored (help)

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