Diagnosis and Treatment of Appendicitis

Publication Date: May 13, 2024
Last Updated: May 31, 2024

Summary of Recommendations

Ultrasound is a reasonable first line study given its low cost and lack of radiation. However, CT and MRI are the most definitive imaging modalities.

(U, CC)
620
The panel suggests that adult and pediatric patients with uncomplicated appendicitis be managed operatively. (low certainty of evidence in adults and very low certainty of evidence in pediatrics) (C, )
620
The panel suggests that adult and pediatric patients with complicated appendicitis be managed operatively. (very low certainty of evidence in adults and low certainty of evidence in pediatrics) (C, )
620
The panel suggests that adult and pediatric patients with uncomplicated appendicitis may undergo either delayed (> 12 h) or immediate operation (< 12 h). (C, VL )
620

The panels suggests that adult and pediatric patients with complicated appendicitis should undergo either suction and lavage or suction alone based on surgeon preference. (very low certainty of evidence in adults and low certainty of evidence in pediatrics)

(C, )
620
The panel suggests no routine drain placement for both adult and pediatric patients undergoing appendectomy for complicated appendicitis. (C, VL )
620
The panel suggests that adult and pediatric patients who have undergone appendectomy for complicated appendicitis should be treated with short-term antibiotics postoperatively. (C, VL )
620
The panel suggests adult patients with complicated appendicitis previously treated nonoperatively should have an interval appendectomy. (low certainty of evidence in adults and expert opinion in pediatrics) (C, )
620

Recommendation Grading

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Overview

Title

Diagnosis and Treatment of Appendicitis

Authoring Organization

Society of American Gastrointestinal and Endoscopic Surgeons

Publication Month/Year

May 13, 2024

Last Updated Month/Year

June 11, 2024

Document Type

Guideline

Country of Publication

US

Document Objectives

Appendicitis is an extremely common disease with a variety of medical and surgical treatment approaches. A multidisciplinary expert panel was convened to develop evidence-based recommendations to support clinicians and patients in decisions regarding the diagnosis and treatment of appendicitis.

Inclusion Criteria

Male, Female, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Emergency care, Hospital, Outpatient, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Diagnosis, Assessment and screening, Treatment

Diseases/Conditions (MeSH)

D001064 - Appendicitis

Keywords

appendicitis

Source Citation

Kumar SS, Collings AT, Lamm R, Haskins IN, Scholz S, Nepal P, Train AT, Athanasiadis DI, Pucher PH, Bradley JF 3rd, Hanna NM, Quinteros F, Narula N, Slater BJ. SAGES guideline for the diagnosis and treatment of appendicitis. Surg Endosc. 2024 Jun;38(6):2974-2994. doi: 10.1007/s00464-024-10813-y. Epub 2024 May 13. PMID: 38740595.