ACUTE APPENDICITIS, PANORAMIC REVIEW

Abstract

Introduction: appendicitis is distinguished by inflammation of the vermiform appendix and usually shows acutely within the first 24 hours. Acute appendicitis is the main source of abdominal surgery in children and the most common abdominal surgical emergency around the globe. Objective: to detail the current information related to acute appendicitis, etiology, epidemiology, pathophysiology, histopathology, anamnesis, physical examination, evaluation, treatment and complications of the disease. Methodology: a total of 37 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 25 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: acute appendicitis, abdominal pain, appendix, abdominal surgery, acute abdominal treatment. Results: appendectomy by open laparotomy or laparoscopy is the standard treatment for acute appendicitis, however, intravenous antibiotics are exceptionally considered as first line therapy in individuals. The incidence of acute appendicitis varies from 100 to 223 new cases per 100,000 people per year. This disease can occur at any age, however it is most commonly seen in the age range of 5 to 45 years. The lifetime incidence of acute appendicitis is 8.6% in men and 6.7% in women. The risk of appendiceal rupture may vary with 2% of cases being frequently perforated 36 hours after the onset of symptoms. Conclusions: It is of vital importance to recognize the etiology, epidemiology, pathophysiology, clinical picture and tests that support the diagnostic decision in any case of acute abdomen, especially in cases of acute appendicitis, because an accurate diagnosis will lead us to a rapid intervention, adequate treatment, reducing the risk of mortality and the risk of potential complications in the affected individual. Diagnostic tests and scales play an important role in the diagnosis. The efficacy of antibiotics as primary treatment for uncomplicated acute appendicitis has been extensively investigated, with conflicting and mixed results and conclusions. Comparing the results between individuals who underwent laparoscopic appendectomy and those who underwent open appendectomy, the former group showed a lower incidence of wound infection, a lower level of postoperative analgesic requirement and shorter postoperative hospital stays in the former group, with the main disadvantage being the longer operative time. KEY WORDS: appendicitis, pain, appendix, surgery.