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Appendicitis

delete2025-11-13
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PRE
AI
P
Paulina Salminen *
J
Jussi Haijanen
P
Peter C. Minneci
G
Giana H. Davidson
M
Marja A. Boermeester
E
Ed Livingston
R
Roland E. Andersson
K
Kyoung Ho Lee
D
David R. Flum
DOI:10.1038/s41572-025-00659-6delete
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Abstract

Abstract

En 中文
The appendix is a small, worm-like diverticulum of the caecum, potentially having a role in regulating intestinal microbiota and immunology. Inflammation of the appendix, acute appendicitis, is one of the most common reasons for acute abdominal pain in children and adults and surgical emergency visits worldwide. The pathophysiology of appendicitis is still poorly understood. During the past decade, evidence has overturned the long-lasting dogma that all appendicitis cases have a clinical course inevitably progressing to perforation and life-threatening peritonitis unless operated upon in a timely manner. Instead, this natural course occurs only in a smaller proportion of patients, for whom emergency appendectomy remains mandatory. Advances in diagnostic accuracy following utilization of clinical scoring systems and imaging has enabled more accurate pre-interventional assessment of appendicitis disease severity. While some patients still require urgent surgery, the majority can be treated successfully with antibiotics, and in some the disease has even been shown to resolve spontaneously. This has confirmed the notion of at least two different forms of appendicitis: non-perforating and perforating, often referred to as uncomplicated and complicated appendicitis. Unified definitions of these forms are still undergoing rigorous research and debate, hampering both comparison of different studies and the establishment of unified treatment guidelines. The current knowledge on the safe and effective outcomes of non-operative treatment alternatives has further underlined the need for standardized uniform definitions of appendicitis severity and assessment of the success of two fundamentally different treatment options. Inflammation of the appendix, acute appendicitis, is one of the most common reasons for acute abdominal pain in children and adults and surgical emergency visits worldwide. In this Primer, Salminen and colleagues review the epidemiology, pathophysiology, diagnosis and management of appendicitis, and discuss future research areas.
Keywords:
Appendicitis
Non-perforating appendicitis
Perforating appendicitis
Antibiotic treatment
Surgical management

Journal

N
Nature Reviews Disease Primers
IF:
60.6
Papers:
661
Citations:
4.6W

Organization

D
delaware valley
Scholars:
1
Papers: 1
Citations: 3
U
UCLA School of Medicine
Scholars:
56
Papers: 25
Citations: 13
S
Seoul National University Bundang Hospital
Scholars:
176
Papers: 75
Citations: 24
U
University of Turku
Scholars:
639
Papers: 229
Citations: 3.6K
U
University of Amsterdam
Scholars:
1.1K
Papers: 513
Citations: 1.5W
L
Linköping University
Scholars:
717
Papers: 317
Citations: 5.0K
U
university of washington
Scholars:
4.5K
Papers: 1.5K
Citations: 2.6W
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Cited Papers

Cited Papers

In Brief
err2005-10-01
err0
PREAI
errJay B. Prystowsky; Carla M. Pugh; Alex P. Nagle
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Microbiota of Children With Complex Appendicitis
err2019-10-01
err0
PREAI
errSarah-May M. L. The; Roel Bakx; Andries E. Budding; Tim G. J. de Meij; Johanna H. van der Lee; Madeleine J. Bunders; Linda Poort; Hugo A. Heij; L. W. Ernst van Heurn; Ramon R. Gorter
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The Worldwide Epidemiology of Acute Appendicitis: An Analysis of the Global Health Data Exchange Dataset
err2021-03-23
err0
PREAI
errDakshitha P. Wickramasinghe; Chrisjit Xavier; Dharmabandhu N. Samarasekera
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Appendicolith classification: physical and chemical properties of appendicoliths in patients with CT diagnosed acute appendicitis - a prospective cohort study
err2024-08-19
err1
errOAAI
errVanhatalo, Sanja; Makila, Ermei; Hakanen, Antti J.; Munukka, Eveliina; Salonen, Jarno; Saarinen, Timo; Groenroos, Juha; Sippola, Suvi; Salminen, Paulina
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Scoring system to distinguish uncomplicated from complicated acute appendicitis
err2015-05-12
err152
errOAAI
errAtema, J. J.; van Rossem, C. C.; Leeuwenburgh, M. M.; Stoker, J.; Boermeester, M. A.
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Culture-based bacterial evaluation of the appendix lumen in patients with and without acute appendicitis
err2019-09-01
err0
PREAI
errTakuya Hattori; Norihiro Yuasa; Shinobu Ikegami; Hideki Nishiyama; Eiji Takeuchi; Hideo Miyake; Remi Kuno; Kanji Miyata; Masahiko Fujino; Masaaki Minami
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