Fast Five Quiz: Appendicitis

Medscape

6 days ago

Although the hallmark signs of appendicitis are well known, diagnosis and management evolve. Factors such as the patient's sex, season of presentation, and preceding procedures can influence clinical decision-making and complicate the diagnostic picture. Meanwhile, discussions abound around new treatment options such as nonoperative management with antibiotics and surgical options, including open vs laparoscopic appendectomy.
How much do you know about the diagnostic strategies, treatment approaches, and postoperative complications associated with appendicitis? Test your knowledge with this quick quiz.
In a patient presenting with signs suggestive of appendicitis after undergoing a colonoscopy, the preferred imaging tool is CT. CT is highly effective at detecting appendiceal inflammation and can help rule out other potential colonoscopy complications (eg, bowel perforation).
Although ultrasonography might assist in diagnosing appendicitis, its lower sensitivity and operator dependence limit its reliability, especially in post-colonoscopy cases. Radiography lacks the detail needed to visualize the appendix or diagnose appendicitis reliably, making it unsuitable for this purpose. MRI, although capable of detecting appendicitis, is not typically used in acute-care settings due to its cost, limited availability, and longer acquisition time.
Learn more about CT scanning.
Surgical approaches tend to differ by sex, with women more commonly receiving minimally invasive procedures (laparoscopic), whereas men more often undergo open surgeries. However, women have a higher chance of developing surgical complications.
No significant difference in overall analgesia administration is found between men and women. Although antibiotics are sometimes used to treat appendicitis nonsurgically, limited evidence supports significant sex-based preference for this method, and it is not widely practiced as a standard alternative to surgery.
Learn more about laparoscopic appendectomy.
Appendicitis tends to occur more frequently during the summer months, as shown in research examining seasonal fluctuations in diagnosis rates. This pattern has been seen in both males and females, with a notable rise in cases during warmer weather, although the exact reason for this increase remains uncertain.
Spring and winter do not show as strong a correlation as summer. Fall has not been linked with a noticeable rise in appendicitis cases.
Learn more about appendicitis.
After an appendectomy, the most frequent issue facing patients is infection at the site of the surgical incision. This complication remains the leading postoperative concern regardless of the surgical technique used.
Hernia is not commonly seen after an appendectomy and tends to develop later, often related to improper wound healing or incisional stress. Septicemia and intestinal obstruction are common complications after appendectomy, although they occur less frequently than wound infection.
Learn more about hernias.
Appendectomy remains the preferred treatment for uncomplicated acute appendicitis, as it consistently offers reliable results and a lower risk for recurrence compared to antibiotics.
Although antibiotic therapy can be a safe option for selected patients, especially those aiming to avoid surgery, it carries the potential for treatment failure and future recurrence. Antibiotics are typically the treatment of choice for delayed presentations of appendicitis that are associated with phlegmon formation. Patients who initially receive antibiotics and later need surgery do not appear to have a higher rate of perforation than those who undergo surgery from the outset.
Learn more about appendectomies.