ERAT: A New ERA for Appendicitis Therapy?

Excerpt

Appendicitis, a common cause of acute abdomen, usually occurs in the 2nd or 3rd decade of life with an incidence of 233/100,000 [1]. Its pathophysiology is thought to result from appendiceal obstruction due to fecal material, undigested food, foreign body, enlarged lymphoid follicles, stenosis, or twisting of the organ. Initial clinical manifestations include right lower quadrant abdominal pain, nausea, vomiting, and low-grade fever. Classic physical findings such as tenderness at McBurney’s point (1.5–2 in. from the anterior superior iliac spine [ASIS] on a straight line from the ASIS to the umbilicus), psoas sign (right lower quadrant pain with passive right hip extension), and Rovsing’s sign (pain in the right lower quadrant with palpation of left lower quadrant) either may not be present early in the disease course or are difficult to elicit in an acute abdomen. Leukocytosis is the only consistently abnormal routine laboratory abnormality [2]. …