The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Acute Appendicitis (Clinical Assessment)

Stages, scoring systems and current treatment algorithm for acute inflammation of the appendix.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Acute Appendicitis (Clinical Assessment)?

Acute appendicitis is an acute inflammatory process triggered by obstruction of the appendiceal lumen (faecolith, lymphoid hyperplasia, parasites). It can affect any age group but is most common between 10 and 30 years and is the most frequent emergency surgical indication in general surgery.

Clinically it is divided into four stages: catarrhal (superficial), phlegmonous (involving all layers), gangrenous and perforated. The perforated stage is complicated by peritonitis and intra-abdominal abscess, with a markedly increased mortality risk.

The Alvarado score (MANTRELS) and the AIR (Appendicitis Inflammatory Response) score help the clinician with risk stratification. In doubtful cases, contrast-enhanced CT or ultrasound confirms the diagnosis; CT sensitivity is 94–98%.

Symptoms

Pain that migrates from the periumbilical region to the right lower quadrant (McBurney point tenderness)
Fever (37.5–38.5°C; above 39°C in perforated cases)
Nausea, vomiting and loss of appetite
Rebound tenderness and guarding
Rovsing sign: pressure in the left lower quadrant elicits pain in the right lower quadrant
Psoas sign: pain on passive extension of the right hip
Obturator sign: pain on internal rotation of the flexed right hip

Risk Factors

Age 10–30 years (peak incidence)
Male sex (1.4:1 ratio)
Low-fibre Western-type diet
Family history of appendicitis
Previous gastrointestinal infections
Immunosuppressed patients (atypical presentation)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Right lower quadrant pain that progressively worsens over hours
  • Abdominal tenderness with fever
  • Pain that suddenly eases and then spreads across the whole abdomen (perforation)
  • Atypical abdominal pain, especially in children and the elderly
  • Right-sided abdominal pain in pregnant women

Treatment Methods

01
Laparoscopic appendicectomy: the standard treatment with low complication rates and a short hospital stay
02
Open appendicectomy: in perforated or complicated cases or when laparoscopy cannot be performed
03
Antibiotics-first strategy: in selected uncomplicated cases, taking a 20–30% recurrence rate into account
04
Percutaneous drainage: for localised abscess in perforated cases, with elective appendicectomy 6–8 weeks later
05
Preoperative intravenous antibiotic prophylaxis (cefazolin ± metronidazole)
06
Delayed-discharge oral antibiotic course and wound-care education

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Genel Cerrahi Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Appendicitis

Genel Cerrahi

Appendicitis is inflammation of the appendix causing severe pain in the lower right abdomen. Early diagnosis and surgical treatment are life-saving.

Inguinal Hernia

Genel Cerrahi

Inguinal hernia is the protrusion of intestine or fat into the inguinal canal due to weakness in the abdominal wall. It can be permanently corrected with surgical treatment.

Umbilical Hernia

Genel Cerrahi

Umbilical hernia manifests as a soft swelling around the navel. While it often resolves spontaneously in infants, surgical treatment may be required in adults.

Gallstones and Cholecystectomy

Genel Cerrahi

Gallstones cause severe pain in the upper right abdomen, especially after fatty meals. They are safely treated with laparoscopic cholecystectomy.

Hemorrhoids (Piles)

Genel Cerrahi

Hemorrhoids result from swelling of the veins in the anus; they present with blood on toilet paper, itching, and pain. Various treatments are available, from lifestyle changes to surgery.

Anal Fissure

Genel Cerrahi

Anal fissure is a tear in the thin skin of the anal canal. It presents with sharp pain and bleeding and can be healed with medical or surgical treatment.

Pilonidal Sinus

Genel Cerrahi

Pilonidal sinus consists of tunnels and tracts prone to chronic infection, formed by hair becoming embedded under the skin in the tailbone area. Surgical treatment provides a permanent solution.

Thyroid Surgery

Genel Cerrahi

Thyroid surgery involves the removal of part or all of the thyroid gland for indications such as benign nodules, goiter, and thyroid cancer.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.