Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
|Section 9. Gastrointestinal Emergencies >|
Chapter 84. Acute Appendicitis
Sections: Epidemiology, Pathophysiology, Clinical Features, Diagnosis, Treatment, Disposition and Follow-Up, Special Populations, Acknowledgments, References.
Topics Discussed: appendicitis, acute.
Excerpt:"More than 300,000 appendectomies for acute appendicitis are performed
each year in the U.S.,1 with an additional 700,000
patients affected in the European community.2 Although
some studies suggest that the incidence of acute uncomplicated appendicitis
is falling in Western countries, the incidence of complicated appendicitis
(e.g., perforation) may actually be increasing.3,4 It
has been estimated that the lifetime risk of developing acute appendicitis
in the U.S. is 12% for males and 25% for females.5 Appendicitis
remains the most common etiology of atraumatic abdominal pain in
children >1 year old6 and is the most common nonobstetric
surgical emergency in pregnancy, complicating up to 1 in 1500 pregnancies.7,8 Despite
technologic advances in lab testing and imaging, accurate diagnosis
is a challenge. Both "missed appendicitis" and unnecessary
surgery for a false diagnosis are not without consequence. Thus,
consider appendicitis in any patient with acute atraumatic abdominal
pain without a previous appendectomy...."
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