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class="vector-toc-numb">2</span> <span>Causes</span> </div> </a> <ul id="toc-Causes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Diagnosis</span> </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Diagnosis subsection</span> </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Signs" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Signs"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Signs</span> </div> </a> <ul id="toc-Signs-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Laboratory_tests" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Laboratory_tests"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Laboratory tests</span> </div> </a> <ul id="toc-Laboratory_tests-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Imaging" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Imaging"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3</span> <span>Imaging</span> </div> </a> <ul id="toc-Imaging-sublist" class="vector-toc-list"> <li id="toc-Ultrasound" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Ultrasound"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.1</span> <span>Ultrasound</span> </div> </a> <ul id="toc-Ultrasound-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Computed_tomography" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Computed_tomography"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.2</span> <span>Computed tomography</span> </div> </a> <ul id="toc-Computed_tomography-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Magnetic_resonance_imaging" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Magnetic_resonance_imaging"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.3</span> <span>Magnetic resonance imaging</span> </div> </a> <ul id="toc-Magnetic_resonance_imaging-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-X-ray" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#X-ray"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3.4</span> <span>X-ray</span> </div> </a> <ul id="toc-X-ray-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Scoring_systems" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Scoring_systems"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4</span> <span>Scoring systems</span> </div> </a> <ul id="toc-Scoring_systems-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pathology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pathology"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.5</span> <span>Pathology</span> </div> </a> <ul id="toc-Pathology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Differential_diagnosis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Differential_diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.6</span> <span>Differential diagnosis</span> </div> </a> <ul id="toc-Differential_diagnosis-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Management</span> </div> </a> <button aria-controls="toc-Management-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Management subsection</span> </button> <ul id="toc-Management-sublist" class="vector-toc-list"> <li id="toc-Pain" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pain"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Pain</span> </div> </a> <ul id="toc-Pain-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Surgery</span> </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> <li id="toc-Open_appendectomy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Open_appendectomy"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2.1</span> <span>Open appendectomy</span> </div> </a> <ul id="toc-Open_appendectomy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Laparoscopic_appendectomy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Laparoscopic_appendectomy"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2.2</span> <span>Laparoscopic appendectomy</span> </div> </a> <ul id="toc-Laparoscopic_appendectomy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Laparoscopic-assisted_transumbilical_appendectomy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Laparoscopic-assisted_transumbilical_appendectomy"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2.3</span> <span>Laparoscopic-assisted transumbilical appendectomy</span> </div> </a> <ul id="toc-Laparoscopic-assisted_transumbilical_appendectomy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pre-surgery" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Pre-surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2.4</span> <span>Pre-surgery</span> </div> </a> <ul id="toc-Pre-surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-After_surgery" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#After_surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2.5</span> <span>After surgery</span> </div> </a> <ul id="toc-After_surgery-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Prognosis</span> </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Appendicitis</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 86 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-86" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">86 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A7%D9%84%D8%AA%D9%87%D8%A7%D8%A8_%D8%A7%D9%84%D8%B2%D8%A7%D8%A6%D8%AF%D8%A9_%D8%A7%D9%84%D8%AF%D9%88%D8%AF%D9%8A%D8%A9" title="التهاب الزائدة الدودية – Arabic" lang="ar" hreflang="ar" data-title="التهاب الزائدة الدودية" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-an mw-list-item"><a href="https://an.wikipedia.org/wiki/Apendicitis" title="Apendicitis – Aragonese" lang="an" hreflang="an" data-title="Apendicitis" data-language-autonym="Aragonés" data-language-local-name="Aragonese" class="interlanguage-link-target"><span>Aragonés</span></a></li><li class="interlanguage-link interwiki-as mw-list-item"><a href="https://as.wikipedia.org/wiki/%E0%A6%8F%E0%A6%AA%E0%A7%87%E0%A6%A3%E0%A7%8D%E0%A6%A1%E0%A6%BF%E0%A6%9B%E0%A6%BE%E0%A6%87%E0%A6%9F%E0%A6%BF%E0%A6%9B" title="এপেণ্ডিছাইটিছ – Assamese" lang="as" hreflang="as" data-title="এপেণ্ডিছাইটিছ" data-language-autonym="অসমীয়া" data-language-local-name="Assamese" class="interlanguage-link-target"><span>অসমীয়া</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Appendisit" title="Appendisit – Azerbaijani" lang="az" hreflang="az" data-title="Appendisit" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%A2%D9%BE%D8%A7%D9%86%D8%AF%DB%8C%D8%B3%DB%8C%D8%AA" title="آپاندیسیت – South Azerbaijani" lang="azb" hreflang="azb" data-title="آپاندیسیت" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%85%E0%A7%8D%E0%A6%AF%E0%A6%BE%E0%A6%AA%E0%A7%87%E0%A6%A8%E0%A7%8D%E0%A6%A1%E0%A6%BF%E0%A6%B8%E0%A6%BE%E0%A6%87%E0%A6%9F%E0%A6%BF%E0%A6%B8" title="অ্যাপেন্ডিসাইটিস – Bangla" lang="bn" hreflang="bn" data-title="অ্যাপেন্ডিসাইটিস" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%90%D0%BF%D0%B5%D0%BD%D0%B4%D1%8B%D1%86%D1%8B%D1%82" title="Апендыцыт – Belarusian" lang="be" hreflang="be" data-title="Апендыцыт" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%90%D0%BF%D1%8D%D0%BD%D0%B4%D1%8B%D1%86%D1%8B%D1%82" title="Апэндыцыт – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Апэндыцыт" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target"><span>Беларуская (тарашкевіца)</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%90%D0%BF%D0%B5%D0%BD%D0%B4%D0%B8%D1%86%D0%B8%D1%82" title="Апендицит – Bulgarian" lang="bg" hreflang="bg" data-title="Апендицит" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Upala_crvuljka" title="Upala crvuljka – Bosnian" lang="bs" hreflang="bs" data-title="Upala crvuljka" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Apendicitis" title="Apendicitis – Catalan" lang="ca" hreflang="ca" data-title="Apendicitis" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Apendicitida" title="Apendicitida – Czech" lang="cs" hreflang="cs" data-title="Apendicitida" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-cy mw-list-item"><a href="https://cy.wikipedia.org/wiki/Llid_y_coluddyn_crog" title="Llid y coluddyn crog – Welsh" lang="cy" hreflang="cy" data-title="Llid y coluddyn crog" data-language-autonym="Cymraeg" data-language-local-name="Welsh" class="interlanguage-link-target"><span>Cymraeg</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Blindtarmsbet%C3%A6ndelse" title="Blindtarmsbetændelse – Danish" lang="da" hreflang="da" data-title="Blindtarmsbetændelse" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Appendizitis" title="Appendizitis – German" lang="de" hreflang="de" data-title="Appendizitis" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%87%DE%AC%DE%95%DE%AC%DE%82%DE%B0%DE%91%DE%A8%DE%86%DE%B0%DE%90%DE%B0_%DE%8B%DE%AA%DE%85%DE%A6%DE%88%DE%AA%DE%82%DE%B0" title="އެޕެންޑިކްސް ދުޅަވުން – Divehi" lang="dv" hreflang="dv" data-title="އެޕެންޑިކްސް ދުޅަވުން" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target"><span>ދިވެހިބަސް</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%A3%CE%BA%CF%89%CE%BB%CE%B7%CE%BA%CE%BF%CE%B5%CE%B9%CE%B4%CE%AF%CF%84%CE%B9%CE%B4%CE%B1" title="Σκωληκοειδίτιδα – Greek" lang="el" hreflang="el" data-title="Σκωληκοειδίτιδα" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Apendicitis" title="Apendicitis – Spanish" lang="es" hreflang="es" data-title="Apendicitis" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Apendicito" title="Apendicito – Esperanto" lang="eo" hreflang="eo" data-title="Apendicito" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Apendizitis" title="Apendizitis – Basque" lang="eu" hreflang="eu" data-title="Apendizitis" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A2%D9%BE%D8%A7%D9%86%D8%AF%DB%8C%D8%B3%DB%8C%D8%AA" title="آپاندیسیت – Persian" lang="fa" hreflang="fa" data-title="آپاندیسیت" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Appendicite" title="Appendicite – French" lang="fr" hreflang="fr" data-title="Appendicite" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Aipindic%C3%ADteas" title="Aipindicíteas – Irish" lang="ga" hreflang="ga" data-title="Aipindicíteas" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Apendicite" title="Apendicite – Galician" lang="gl" hreflang="gl" data-title="Apendicite" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-hak mw-list-item"><a href="https://hak.wikipedia.org/wiki/Chho%CC%8Dk-thi%C3%AAn-tiau" title="Chho̍k-thiên-tiau – Hakka Chinese" lang="hak" hreflang="hak" data-title="Chho̍k-thiên-tiau" data-language-autonym="客家語 / Hak-kâ-ngî" data-language-local-name="Hakka Chinese" class="interlanguage-link-target"><span>客家語 / Hak-kâ-ngî</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%B6%A9%EC%88%98%EC%97%BC" title="충수염 – Korean" lang="ko" hreflang="ko" data-title="충수염" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Appendicitis" title="Appendicitis – Hausa" lang="ha" hreflang="ha" data-title="Appendicitis" data-language-autonym="Hausa" data-language-local-name="Hausa" class="interlanguage-link-target"><span>Hausa</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%88%D6%80%D5%A4%D5%A1%D5%B6%D5%B4%D5%A1%D5%B6_%D5%A5%D5%AC%D5%B8%D6%82%D5%B6%D5%AB_%D5%A2%D5%B8%D6%80%D5%A2%D5%B8%D6%84%D5%B8%D6%82%D5%B4" title="Որդանման ելունի բորբոքում – Armenian" lang="hy" hreflang="hy" data-title="Որդանման ելունի բորբոքում" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%86%E0%A4%82%E0%A4%A4_%E0%A4%AE%E0%A5%87%E0%A4%82_%E0%A4%89%E0%A4%AA%E0%A4%BE%E0%A4%82%E0%A4%A4%E0%A5%8D%E0%A4%B0_%E0%A4%B6%E0%A5%8B%E0%A4%A5-%E0%A4%8F%E0%A4%AA%E0%A5%87%E0%A4%82%E0%A4%A1%E0%A4%BF%E0%A4%B8%E0%A4%BE%E0%A4%87%E0%A4%9F%E0%A4%BF%E0%A4%B8" title="आंत में उपांत्र शोथ-एपेंडिसाइटिस – Hindi" lang="hi" hreflang="hi" data-title="आंत में उपांत्र शोथ-एपेंडिसाइटिस" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Upala_crvuljka" title="Upala crvuljka – Croatian" lang="hr" hreflang="hr" data-title="Upala crvuljka" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Apendicito" title="Apendicito – Ido" lang="io" hreflang="io" data-title="Apendicito" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target"><span>Ido</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Apendisitis" title="Apendisitis – Indonesian" lang="id" hreflang="id" data-title="Apendisitis" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-ia mw-list-item"><a href="https://ia.wikipedia.org/wiki/Appendicitis" title="Appendicitis – Interlingua" lang="ia" hreflang="ia" data-title="Appendicitis" data-language-autonym="Interlingua" data-language-local-name="Interlingua" class="interlanguage-link-target"><span>Interlingua</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Appendicite" title="Appendicite – Italian" lang="it" hreflang="it" data-title="Appendicite" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%93%D7%9C%D7%A7%D7%AA_%D7%94%D7%AA%D7%95%D7%A1%D7%A4%D7%AA%D7%9F" title="דלקת התוספתן – Hebrew" lang="he" hreflang="he" data-title="דלקת התוספתן" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-kn mw-list-item"><a href="https://kn.wikipedia.org/wiki/%E0%B2%95%E0%B2%B0%E0%B3%81%E0%B2%B3%E0%B3%81%E0%B2%B5%E0%B2%BE%E0%B2%B3%E0%B3%81%E0%B2%B0%E0%B2%BF%E0%B2%A4(%E0%B2%85%E0%B2%AA%E0%B3%86%E0%B2%82%E0%B2%A1%E0%B2%BF%E0%B2%95%E0%B3%8D%E0%B2%B8%E0%B3%8D%E2%80%8C)" title="ಕರುಳುವಾಳುರಿತ(ಅಪೆಂಡಿಕ್ಸ್‌) – Kannada" lang="kn" hreflang="kn" data-title="ಕರುಳುವಾಳುರಿತ(ಅಪೆಂಡಿಕ್ಸ್‌)" data-language-autonym="ಕನ್ನಡ" data-language-local-name="Kannada" class="interlanguage-link-target"><span>ಕನ್ನಡ</span></a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%90%E1%83%9E%E1%83%94%E1%83%9C%E1%83%93%E1%83%98%E1%83%AA%E1%83%98%E1%83%A2%E1%83%98" title="აპენდიციტი – Georgian" lang="ka" hreflang="ka" data-title="აპენდიციტი" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target"><span>ქართული</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%A1%D0%BE%D2%9B%D1%8B%D1%80%D1%96%D1%88%D0%B5%D0%BA" title="Соқырішек – Kazakh" lang="kk" hreflang="kk" data-title="Соқырішек" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Uvimbe_wa_kidole_tumbo" title="Uvimbe wa kidole tumbo – Swahili" lang="sw" hreflang="sw" data-title="Uvimbe wa kidole tumbo" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target"><span>Kiswahili</span></a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/Apand%C3%AEs%C3%AEt" title="Apandîsît – Kurdish" lang="ku" hreflang="ku" data-title="Apandîsît" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target"><span>Kurdî</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%90%D0%BF%D0%BF%D0%B5%D0%BD%D0%B4%D0%B8%D1%86%D0%B8%D1%82" title="Аппендицит – Kyrgyz" lang="ky" hreflang="ky" data-title="Аппендицит" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Appendicitis" title="Appendicitis – Latin" lang="la" hreflang="la" data-title="Appendicitis" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/Apendic%C4%ABts" title="Apendicīts – Latvian" lang="lv" hreflang="lv" data-title="Apendicīts" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target"><span>Latviešu</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Apendicitas" title="Apendicitas – Lithuanian" lang="lt" hreflang="lt" data-title="Apendicitas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Heveny_f%C3%A9regny%C3%BAlv%C3%A1ny-gyullad%C3%A1s" title="Heveny féregnyúlvány-gyulladás – Hungarian" lang="hu" hreflang="hu" data-title="Heveny féregnyúlvány-gyulladás" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%90%D0%BF%D0%B5%D0%BD%D0%B4%D0%B8%D1%86%D0%B8%D1%82" title="Апендицит – Macedonian" lang="mk" hreflang="mk" data-title="Апендицит" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%85%E0%B4%AA%E0%B5%8D%E0%B4%AA%E0%B5%86%E0%B5%BB%E0%B4%A1%E0%B4%BF%E0%B4%B8%E0%B5%88%E0%B4%B1%E0%B5%8D%E0%B4%B1%E0%B4%BF%E0%B4%B8%E0%B5%8D" title="അപ്പെൻഡിസൈറ്റിസ് – Malayalam" lang="ml" hreflang="ml" data-title="അപ്പെൻഡിസൈറ്റിസ്" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-mt mw-list-item"><a href="https://mt.wikipedia.org/wiki/Appendi%C4%8Bite" title="Appendiċite – Maltese" lang="mt" hreflang="mt" data-title="Appendiċite" data-language-autonym="Malti" data-language-local-name="Maltese" class="interlanguage-link-target"><span>Malti</span></a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Apendisitis" title="Apendisitis – Malay" lang="ms" hreflang="ms" data-title="Apendisitis" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target"><span>Bahasa Melayu</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Blindedarmontsteking" title="Blindedarmontsteking – Dutch" lang="nl" hreflang="nl" data-title="Blindedarmontsteking" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ne mw-list-item"><a href="https://ne.wikipedia.org/wiki/%E0%A4%8F%E0%A4%AA%E0%A5%87%E0%A4%A8%E0%A5%8D%E0%A4%A1%E0%A4%BF%E0%A4%B8%E0%A4%BE%E0%A4%87%E0%A4%9F%E0%A4%BF%E0%A4%B8" title="एपेन्डिसाइटिस – Nepali" lang="ne" hreflang="ne" data-title="एपेन्डिसाइटिस" data-language-autonym="नेपाली" data-language-local-name="Nepali" class="interlanguage-link-target"><span>नेपाली</span></a></li><li class="interlanguage-link interwiki-new mw-list-item"><a href="https://new.wikipedia.org/wiki/%E0%A4%8F%E0%A4%AA%E0%A5%87%E0%A4%A8%E0%A5%8D%E0%A4%A1%E0%A4%BF%E0%A4%B8%E0%A4%BE%E0%A4%87%E0%A4%9F%E0%A4%BF%E0%A4%B8" title="एपेन्डिसाइटिस – Newari" lang="new" hreflang="new" data-title="एपेन्डिसाइटिस" data-language-autonym="नेपाल भाषा" data-language-local-name="Newari" class="interlanguage-link-target"><span>नेपाल भाषा</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%99%AB%E5%9E%82%E7%82%8E" title="虫垂炎 – Japanese" lang="ja" hreflang="ja" data-title="虫垂炎" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Appendisitt" title="Appendisitt – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Appendisitt" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-oc mw-list-item"><a href="https://oc.wikipedia.org/wiki/Apendiciti" title="Apendiciti – Occitan" lang="oc" hreflang="oc" data-title="Apendiciti" data-language-autonym="Occitan" data-language-local-name="Occitan" class="interlanguage-link-target"><span>Occitan</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%86%E0%AC%AA%E0%AD%87%E0%AC%A3%E0%AD%8D%E0%AC%A1%E0%AC%BF%E0%AC%B8%E0%AC%BE%E0%AC%87%E0%AC%9F%E0%AC%BF%E0%AC%B8" title="ଆପେଣ୍ଡିସାଇଟିସ – Odia" lang="or" hreflang="or" data-title="ଆପେଣ୍ଡିସାଇଟିସ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-uz badge-Q17437798 badge-goodarticle mw-list-item" title="good article badge"><a href="https://uz.wikipedia.org/wiki/Appenditsit" title="Appenditsit – Uzbek" lang="uz" hreflang="uz" data-title="Appenditsit" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Zapalenie_wyrostka_robaczkowego" title="Zapalenie wyrostka robaczkowego – Polish" lang="pl" hreflang="pl" data-title="Zapalenie wyrostka robaczkowego" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Apendicite" title="Apendicite – Portuguese" lang="pt" hreflang="pt" data-title="Apendicite" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Apendicit%C4%83" title="Apendicită – Romanian" lang="ro" hreflang="ro" data-title="Apendicită" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%90%D0%BF%D0%BF%D0%B5%D0%BD%D0%B4%D0%B8%D1%86%D0%B8%D1%82" title="Аппендицит – Russian" lang="ru" hreflang="ru" data-title="Аппендицит" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sah mw-list-item"><a href="https://sah.wikipedia.org/wiki/%D0%9C%D1%83%D2%A5%D1%83%D1%80%D0%B4%D0%B0%D0%B0%D1%85_%D1%8B%D0%B0%D1%80%D1%8B%D1%8B%D1%82%D0%B0" title="Муҥурдаах ыарыыта – Yakut" lang="sah" hreflang="sah" data-title="Муҥурдаах ыарыыта" data-language-autonym="Саха тыла" data-language-local-name="Yakut" class="interlanguage-link-target"><span>Саха тыла</span></a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B6%8B%E0%B6%AB%E0%B7%8A%E0%B6%A9%E0%B7%94%E0%B6%9A%E0%B6%B4%E0%B7%94%E0%B6%A0%E0%B7%8A%E0%B6%A1_%E0%B6%B4%E0%B7%8A%E2%80%8D%E0%B6%BB%E0%B6%AF%E0%B7%8F%E0%B7%84%E0%B6%BA_(%E0%B6%87%E0%B6%B4%E0%B7%99%E0%B6%B1%E0%B7%8A%E0%B6%A9%E0%B7%92%E0%B7%83%E0%B6%BA%E0%B7%92%E0%B6%A7%E0%B7%93%E0%B7%83%E0%B7%8A)" title="උණ්ඩුකපුච්ඡ ප්‍රදාහය (ඇපෙන්ඩිසයිටීස්) – Sinhala" lang="si" hreflang="si" data-title="උණ්ඩුකපුච්ඡ ප්‍රදාහය (ඇපෙන්ඩිසයිටීස්)" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target"><span>සිංහල</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Appendicitis" title="Appendicitis – Simple English" lang="en-simple" hreflang="en-simple" data-title="Appendicitis" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Ak%C3%BAtna_apendicit%C3%ADda" title="Akútna apendicitída – Slovak" lang="sk" hreflang="sk" data-title="Akútna apendicitída" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Akutni_apendicitis" title="Akutni apendicitis – Slovenian" lang="sl" hreflang="sl" data-title="Akutni apendicitis" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%DA%95%DB%8C%D8%AE%DB%86%DA%B5%DB%95%DA%A9%D9%88%DB%8E%D8%B1%DB%95%D8%B3%DB%86" title="ڕیخۆڵەکوێرەسۆ – Central Kurdish" lang="ckb" hreflang="ckb" data-title="ڕیخۆڵەکوێرەسۆ" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target"><span>کوردی</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Apendicitis" title="Apendicitis – Serbian" lang="sr" hreflang="sr" data-title="Apendicitis" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Apendicitis" title="Apendicitis – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Apendicitis" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Umpilis%C3%A4ketulehdus" title="Umpilisäketulehdus – Finnish" lang="fi" hreflang="fi" data-title="Umpilisäketulehdus" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Blindtarmsinflammation" title="Blindtarmsinflammation – Swedish" lang="sv" hreflang="sv" data-title="Blindtarmsinflammation" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Apendisitis" title="Apendisitis – Tagalog" lang="tl" hreflang="tl" data-title="Apendisitis" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%95%E0%AF%81%E0%AE%9F%E0%AE%B2%E0%AF%8D%E0%AE%B5%E0%AE%BE%E0%AE%B2%E0%AE%B4%E0%AE%B1%E0%AF%8D%E0%AE%9A%E0%AE%BF" title="குடல்வாலழற்சி – Tamil" lang="ta" hreflang="ta" data-title="குடல்வாலழற்சி" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%90%D0%BF%D0%BF%D0%B5%D0%BD%D0%B4%D0%B8%D1%86%D0%B8%D1%82" title="Аппендицит – Tatar" lang="tt" hreflang="tt" data-title="Аппендицит" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target"><span>Татарча / tatarça</span></a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%85%E0%B0%AA%E0%B1%86%E0%B0%82%E0%B0%A1%E0%B0%BF%E0%B0%B8%E0%B1%88%E0%B0%9F%E0%B0%BF%E0%B0%B8%E0%B1%8D" title="అపెండిసైటిస్ – Telugu" lang="te" hreflang="te" data-title="అపెండిసైటిస్" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target"><span>తెలుగు</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B9%84%E0%B8%AA%E0%B9%89%E0%B8%95%E0%B8%B4%E0%B9%88%E0%B8%87%E0%B8%AD%E0%B8%B1%E0%B8%81%E0%B9%80%E0%B8%AA%E0%B8%9A" title="ไส้ติ่งอักเสบ – Thai" lang="th" hreflang="th" data-title="ไส้ติ่งอักเสบ" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tg mw-list-item"><a href="https://tg.wikipedia.org/wiki/%D0%90%D0%BF%D0%BF%D0%B5%D0%BD%D0%B4%D0%B8%D1%81%D0%B8%D1%82" title="Аппендисит – Tajik" lang="tg" hreflang="tg" data-title="Аппендисит" data-language-autonym="Тоҷикӣ" data-language-local-name="Tajik" class="interlanguage-link-target"><span>Тоҷикӣ</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Apandisit" title="Apandisit – Turkish" lang="tr" hreflang="tr" data-title="Apandisit" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-tk mw-list-item"><a href="https://tk.wikipedia.org/wiki/K%C3%B6ri%C3%A7ege" title="Köriçege – Turkmen" lang="tk" hreflang="tk" data-title="Köriçege" data-language-autonym="Türkmençe" data-language-local-name="Turkmen" class="interlanguage-link-target"><span>Türkmençe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%90%D0%BF%D0%B5%D0%BD%D0%B4%D0%B8%D1%86%D0%B8%D1%82" title="Апендицит – Ukrainian" lang="uk" hreflang="uk" data-title="Апендицит" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%D8%B2%D8%A7%D8%A6%D8%AF_%D8%A2%D9%86%D8%AA_%DA%A9%DB%8C_%D8%B3%D9%88%D8%B2%D8%B4" title="زائد آنت کی سوزش – Urdu" lang="ur" hreflang="ur" data-title="زائد آنت کی سوزش" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target"><span>اردو</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Vi%C3%AAm_ru%E1%BB%99t_th%E1%BB%ABa" title="Viêm ruột thừa – Vietnamese" lang="vi" hreflang="vi" data-title="Viêm ruột thừa" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-wuu mw-list-item"><a href="https://wuu.wikipedia.org/wiki/%E9%98%91%E5%B0%BE%E7%82%8E" title="阑尾炎 – Wu" lang="wuu" hreflang="wuu" data-title="阑尾炎" data-language-autonym="吴语" data-language-local-name="Wu" class="interlanguage-link-target"><span>吴语</span></a></li><li class="interlanguage-link interwiki-zh-yue mw-list-item"><a href="https://zh-yue.wikipedia.org/wiki/%E7%9B%B2%E8%85%B8%E7%82%8E" title="盲腸炎 – Cantonese" lang="yue" hreflang="yue" data-title="盲腸炎" data-language-autonym="粵語" data-language-local-name="Cantonese" class="interlanguage-link-target"><span>粵語</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a 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</nav> </div> </div> </div> <div class="vector-column-end"> <div class="vector-sticky-pinned-container"> <nav class="vector-page-tools-landmark" aria-label="Page tools"> <div id="vector-page-tools-pinned-container" class="vector-pinned-container"> </div> </nav> <nav class="vector-appearance-landmark" aria-label="Appearance"> <div id="vector-appearance-pinned-container" class="vector-pinned-container"> <div id="vector-appearance" class="vector-appearance vector-pinnable-element"> <div class="vector-pinnable-header vector-appearance-pinnable-header vector-pinnable-header-pinned" data-feature-name="appearance-pinned" data-pinnable-element-id="vector-appearance" data-pinned-container-id="vector-appearance-pinned-container" data-unpinned-container-id="vector-appearance-unpinned-container" > <div class="vector-pinnable-header-label">Appearance</div> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-pin-button" 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data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Appendicitis</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Epityphlitis<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Acute_Appendicitis.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6c/Acute_Appendicitis.jpg/220px-Acute_Appendicitis.jpg" decoding="async" width="220" height="90" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6c/Acute_Appendicitis.jpg/330px-Acute_Appendicitis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6c/Acute_Appendicitis.jpg/440px-Acute_Appendicitis.jpg 2x" data-file-width="3037" data-file-height="1247" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">An acutely inflamed and enlarged appendix, sliced lengthwise.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/General_surgery" title="General surgery">General surgery</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">Periumbilical or right lower <a href="/wiki/Abdominal_pain" title="Abdominal pain">abdominal pain</a>, <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, <a href="/wiki/Nausea" title="Nausea">nausea</a>, <a href="/wiki/Anorexia_(symptom)" title="Anorexia (symptom)">decreased appetite</a>,<sup id="cite_ref-Graf1996_2-0" class="reference"><a href="#cite_note-Graf1996-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Fever" title="Fever">high fever</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data"><a href="/wiki/Peritonitis" title="Peritonitis">Abdominal inflammation</a>, <a href="/wiki/Sepsis" title="Sepsis">sepsis</a><sup id="cite_ref-Hob1998_3-0" class="reference"><a href="#cite_note-Hob1998-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Based on symptoms, <a href="/wiki/Medical_imaging" title="Medical imaging">medical imaging</a>, blood tests<sup id="cite_ref-Paul2003_4-0" class="reference"><a href="#cite_note-Paul2003-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="/wiki/Mesenteric_adenitis" class="mw-redirect" title="Mesenteric adenitis">Mesenteric adenitis</a>, <a href="/wiki/Cholecystitis" title="Cholecystitis">cholecystitis</a>, <a href="/wiki/Psoas_abscess" class="mw-redirect" title="Psoas abscess">psoas abscess</a>, <a href="/wiki/Abdominal_aortic_aneurysm" title="Abdominal aortic aneurysm">abdominal aortic aneurysm</a><sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="/wiki/Appendectomy" title="Appendectomy">Surgical removal of the appendix</a>, <a href="/wiki/Antibiotics" class="mw-redirect" title="Antibiotics">antibiotics</a><sup id="cite_ref-Har2012_6-0" class="reference"><a href="#cite_note-Har2012-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Antibiotics2012_7-0" class="reference"><a href="#cite_note-Antibiotics2012-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">11.6 million (2015)<sup id="cite_ref-GBD2015Pre_8-0" class="reference"><a href="#cite_note-GBD2015Pre-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Deaths</th><td class="infobox-data">50,100 (2015)<sup id="cite_ref-GBD2015De_9-0" class="reference"><a href="#cite_note-GBD2015De-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup></td></tr></tbody></table> <p><b>Appendicitis</b> is <a href="/wiki/Inflammation" title="Inflammation">inflammation</a> of the <a href="/wiki/Appendix_(anatomy)" title="Appendix (anatomy)">appendix</a>.<sup id="cite_ref-Graf1996_2-1" class="reference"><a href="#cite_note-Graf1996-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Symptoms commonly include right lower <a href="/wiki/Abdominal_pain" title="Abdominal pain">abdominal pain</a>, <a href="/wiki/Nausea" title="Nausea">nausea</a>, <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, <a href="/wiki/Fever" title="Fever">fever</a> and <a href="/wiki/Anorexia_(symptom)" title="Anorexia (symptom)">decreased appetite</a>.<sup id="cite_ref-Graf1996_2-2" class="reference"><a href="#cite_note-Graf1996-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> However, approximately 40% of people do not have these typical symptoms.<sup id="cite_ref-Graf1996_2-3" class="reference"><a href="#cite_note-Graf1996-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Severe complications of a ruptured appendix include widespread, painful <a href="/wiki/Peritonitis" title="Peritonitis">inflammation of the inner lining of the abdominal wall</a> and <a href="/wiki/Sepsis" title="Sepsis">sepsis</a>.<sup id="cite_ref-Hob1998_3-1" class="reference"><a href="#cite_note-Hob1998-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>Appendicitis is primarily caused by a blockage of the <a href="/wiki/Lumen_(anatomy)" title="Lumen (anatomy)">hollow portion</a> in the appendix.<sup id="cite_ref-Piep1982_10-0" class="reference"><a href="#cite_note-Piep1982-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> This blockage typically results from a <a href="/wiki/Fecalith" title="Fecalith">faecolith</a>, a calcified "stone" made of feces.<sup id="cite_ref-Har2012_6-1" class="reference"><a href="#cite_note-Har2012-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Some studies show a correlation between appendicoliths and disease severity.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Other factors such as inflamed <a href="/wiki/Mucosa-associated_lymphoid_tissue" title="Mucosa-associated lymphoid tissue">lymphoid tissue</a> from a viral infection, <a href="/wiki/Human_parasite" title="Human parasite">intestinal parasites</a>, <a href="/wiki/Gallstone" title="Gallstone">gallstone</a>, or <a href="/wiki/Neoplasm" title="Neoplasm">tumors</a> may also lead to this blockage.<sup id="cite_ref-Har2012_6-2" class="reference"><a href="#cite_note-Har2012-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> When the appendix becomes blocked, it experiences increased pressure, reduced blood flow, and bacterial growth, resulting in inflammation.<sup id="cite_ref-Har2012_6-3" class="reference"><a href="#cite_note-Har2012-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Tint2011_12-0" class="reference"><a href="#cite_note-Tint2011-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> This combination of factors causes tissue injury and, ultimately, tissue death.<sup id="cite_ref-Schw2010_13-0" class="reference"><a href="#cite_note-Schw2010-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> If this process is left untreated, it can lead to the appendix rupturing, which releases bacteria into the <a href="/wiki/Abdominal_cavity" title="Abdominal cavity">abdominal cavity</a>, potentially leading to severe complications.<sup id="cite_ref-Schw2010_13-1" class="reference"><a href="#cite_note-Schw2010-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Barrett2013_14-0" class="reference"><a href="#cite_note-Barrett2013-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>The diagnosis of appendicitis is largely based on the person's signs and symptoms.<sup id="cite_ref-Tint2011_12-1" class="reference"><a href="#cite_note-Tint2011-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> In cases where the diagnosis is unclear, close observation, <a href="/wiki/Medical_imaging" title="Medical imaging">medical imaging</a>, and laboratory tests can be helpful.<sup id="cite_ref-Paul2003_4-1" class="reference"><a href="#cite_note-Paul2003-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> The two most commonly used imaging tests for diagnosing appendicitis are ultrasound and computed tomography (CT scan).<sup id="cite_ref-Paul2003_4-2" class="reference"><a href="#cite_note-Paul2003-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> CT scan is more accurate than ultrasound in detecting acute appendicitis.<sup id="cite_ref-Shogilev2014_15-0" class="reference"><a href="#cite_note-Shogilev2014-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> However, ultrasound may be preferred as the first imaging test in children and pregnant women because of the risks associated with radiation exposure from CT scans.<sup id="cite_ref-Paul2003_4-3" class="reference"><a href="#cite_note-Paul2003-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Although ultrasound may aid in diagnosis, its main role is in identifying important differentials, such as ovarian pathology in females or mesenteric adenitis in children. </p> <figure class="mw-default-size" typeof="mw:File/Thumb"><span><video id="mwe_player_1" poster="//upload.wikimedia.org/wikipedia/commons/thumb/8/84/En.Wikipedia-VideoWiki-Appendicitis.webm/310px-seek%3D70-En.Wikipedia-VideoWiki-Appendicitis.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="310" height="174" data-durationhint="170" data-mwtitle="En.Wikipedia-VideoWiki-Appendicitis.webm" data-mwprovider="wikimediacommons" resource="/wiki/File:En.Wikipedia-VideoWiki-Appendicitis.webm"><source src="//upload.wikimedia.org/wikipedia/commons/8/84/En.Wikipedia-VideoWiki-Appendicitis.webm" type="video/webm; codecs="vp9, opus"" data-width="1280" data-height="720" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/84/En.Wikipedia-VideoWiki-Appendicitis.webm/En.Wikipedia-VideoWiki-Appendicitis.webm.480p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="480p.vp9.webm" data-width="854" data-height="480" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/84/En.Wikipedia-VideoWiki-Appendicitis.webm/En.Wikipedia-VideoWiki-Appendicitis.webm.720p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="720p.vp9.webm" data-width="1280" data-height="720" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/84/En.Wikipedia-VideoWiki-Appendicitis.webm/En.Wikipedia-VideoWiki-Appendicitis.webm.144p.mjpeg.mov" type="video/quicktime" data-transcodekey="144p.mjpeg.mov" data-width="256" data-height="144" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/84/En.Wikipedia-VideoWiki-Appendicitis.webm/En.Wikipedia-VideoWiki-Appendicitis.webm.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="426" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/84/En.Wikipedia-VideoWiki-Appendicitis.webm/En.Wikipedia-VideoWiki-Appendicitis.webm.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="640" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/8/84/En.Wikipedia-VideoWiki-Appendicitis.webm/En.Wikipedia-VideoWiki-Appendicitis.webm.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="640" data-height="360" /><track src="https://commons.wikimedia.org/w/api.php?action=timedtext&title=File%3AEn.Wikipedia-VideoWiki-Appendicitis.webm&lang=en&trackformat=vtt&origin=%2A" kind="subtitles" type="text/vtt" srclang="en" label="English ‪(en)‬" data-dir="ltr" /></video></span><figcaption>Video summary (<a href="/wiki/Wikipedia:VideoWiki/Appendicitis" title="Wikipedia:VideoWiki/Appendicitis">script</a>)</figcaption></figure> <p>The standard treatment for acute appendicitis involves the <a href="/wiki/Appendectomy" title="Appendectomy">surgical removal of the inflamed appendix</a>.<sup id="cite_ref-Har2012_6-4" class="reference"><a href="#cite_note-Har2012-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Tint2011_12-2" class="reference"><a href="#cite_note-Tint2011-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> This procedure can be performed either through an open incision in the abdomen (<a href="/wiki/Laparotomy" title="Laparotomy">laparotomy</a>) or using minimally invasive techniques with small incisions and cameras (<a href="/wiki/Laparoscopy" title="Laparoscopy">laparoscopy</a>). Surgery is essential to reduce the risk of complications or potential death associated with the rupture of the appendix.<sup id="cite_ref-Hob1998_3-2" class="reference"><a href="#cite_note-Hob1998-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Antibiotic" title="Antibiotic">Antibiotics</a> may be equally effective in certain cases of non-ruptured appendicitis,<sup id="cite_ref-BJS_paper_16-0" class="reference"><a href="#cite_note-BJS_paper-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Antibiotics2012_7-1" class="reference"><a href="#cite_note-Antibiotics2012-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> but 31% will undergo appendectomy within one year.<sup id="cite_ref-ReferenceB_18-0" class="reference"><a href="#cite_note-ReferenceB-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> It is one of the most common and significant causes of sudden abdominal <a href="/wiki/Pain" title="Pain">pain</a>. In 2015, approximately 11.6 million cases of appendicitis were reported, resulting in around 50,100 deaths worldwide.<sup id="cite_ref-GBD2015Pre_8-1" class="reference"><a href="#cite_note-GBD2015Pre-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-GBD2015De_9-1" class="reference"><a href="#cite_note-GBD2015De-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> In the United States, appendicitis is one of the most common causes of sudden abdominal pain requiring surgery.<sup id="cite_ref-Graf1996_2-4" class="reference"><a href="#cite_note-Graf1996-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Annually, more than 300,000 individuals in the United States undergo surgical removal of their appendix.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:McBurney%27s_point.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b1/McBurney%27s_point.jpg/290px-McBurney%27s_point.jpg" decoding="async" width="290" height="181" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b1/McBurney%27s_point.jpg/435px-McBurney%27s_point.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b1/McBurney%27s_point.jpg/580px-McBurney%27s_point.jpg 2x" data-file-width="777" data-file-height="486" /></a><figcaption>Location of <a href="/wiki/McBurney%27s_point" title="McBurney's point">McBurney's point</a> (1), located two-thirds the distance from the umbilicus (2) to the right anterior superior iliac spine (3)</figcaption></figure> <p>The presentation of acute appendicitis includes acute abdominal pain, nausea, vomiting, and fever. As the appendix becomes more swollen and inflamed, it begins to irritate the adjoining abdominal wall. This leads the pain to localize at <a href="/wiki/Quadrants_and_regions_of_abdomen" title="Quadrants and regions of abdomen">the right lower quadrant</a>. This classic migration of pain may not appear in children under three years. This pain can be triggered by a sharp pain feeling. Pain from appendicitis may begin as dull pain around the navel. After several hours, the pain usually migrates towards the right lower quadrant, where it becomes localized. Symptoms include localized findings in the right <a href="/wiki/Iliac_fossa" title="Iliac fossa">iliac fossa</a>. The abdominal wall becomes very sensitive to gentle pressure (<a href="/wiki/Palpation" title="Palpation">palpation</a>). There is pain in the sudden release of deep tension in the lower abdomen (<a href="/wiki/Blumberg%27s_sign" title="Blumberg's sign">Blumberg's sign</a>). If the appendix is retrocecal (localized behind the <a href="/wiki/Cecum" title="Cecum">cecum</a>), even deep pressure in the right lower quadrant may fail to elicit tenderness (silent appendix). This is because the <a href="/wiki/Cecum" title="Cecum">cecum</a>, distended with gas, protects the inflamed appendix from pressure. Similarly, if the appendix lies entirely within the pelvis, there is typically a complete absence of abdominal rigidity. In such cases, a digital <a href="/wiki/Rectal_examination" title="Rectal examination">rectal examination</a> elicits tenderness in the rectovesical pouch. Coughing causes point tenderness in this area (<a href="/wiki/McBurney%27s_point" title="McBurney's point">McBurney's point</a>), called <a href="/wiki/Dunphy%27s_sign" title="Dunphy's sign">Dunphy's sign</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Identifying_reliable_sources_(medicine)" title="Wikipedia:Identifying reliable sources (medicine)"><span title="Material near this tag needs references to reliable medical sources. (August 2023)">medical citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=2" title="Edit section: Causes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Stomach_colon_rectum_diagram-en.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d3/Stomach_colon_rectum_diagram-en.svg/220px-Stomach_colon_rectum_diagram-en.svg.png" decoding="async" width="220" height="227" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d3/Stomach_colon_rectum_diagram-en.svg/330px-Stomach_colon_rectum_diagram-en.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d3/Stomach_colon_rectum_diagram-en.svg/440px-Stomach_colon_rectum_diagram-en.svg.png 2x" data-file-width="512" data-file-height="529" /></a><figcaption>Location of the appendix in the <a href="/wiki/Digestive_system" class="mw-redirect" title="Digestive system">digestive system</a></figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:3D_still_showing_appendicitis.jpg" class="mw-file-description"><img alt="3D still showing appendicitis." src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b4/3D_still_showing_appendicitis.jpg/220px-3D_still_showing_appendicitis.jpg" decoding="async" width="220" height="124" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b4/3D_still_showing_appendicitis.jpg/330px-3D_still_showing_appendicitis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b4/3D_still_showing_appendicitis.jpg/440px-3D_still_showing_appendicitis.jpg 2x" data-file-width="1920" data-file-height="1080" /></a><figcaption>3D model of appendicitis.</figcaption></figure> <p>Acute appendicitis seems to be the result of a primary obstruction of the <a href="/wiki/Appendix_(anatomy)" title="Appendix (anatomy)">appendix</a>.<sup id="cite_ref-Wang1937_20-0" class="reference"><a href="#cite_note-Wang1937-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Piep1982_10-1" class="reference"><a href="#cite_note-Piep1982-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Once this obstruction occurs, the appendix becomes filled with <a href="/wiki/Mucus" title="Mucus">mucus</a> and swells. This continued production of mucus leads to increased pressures within the lumen and the walls of the appendix. The increased pressure results in <a href="/wiki/Thrombosis" title="Thrombosis">thrombosis</a> and <a href="/wiki/Vascular_occlusion" title="Vascular occlusion">occlusion</a> of the small vessels, and stasis of <a href="/wiki/Lymphatic_system" title="Lymphatic system">lymphatic flow</a>. At this point, spontaneous recovery rarely occurs. As the occlusion of blood vessels progresses, the appendix becomes <a href="/wiki/Ischemia" title="Ischemia">ischemic</a> and then <a href="/wiki/Necrosis" title="Necrosis">necrotic</a>. As <a href="/wiki/Bacteria" title="Bacteria">bacteria</a> begin to leak out through the dying walls, <a href="/wiki/Pus" title="Pus">pus</a> forms within and around the appendix (suppuration). The result is appendiceal rupture (a 'burst appendix') causing <a href="/wiki/Peritonitis" title="Peritonitis">peritonitis</a>, which may lead to <a href="/wiki/Sepsis" title="Sepsis">sepsis</a> and in rare cases, <a href="/wiki/Death" title="Death">death</a>. These events are responsible for the slowly evolving abdominal pain and other commonly associated symptoms.<sup id="cite_ref-Schw2010_13-2" class="reference"><a href="#cite_note-Schw2010-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>The causative agents include <a href="/wiki/Bezoar" title="Bezoar">bezoars</a>, foreign bodies, <a href="/wiki/Physical_trauma" class="mw-redirect" title="Physical trauma">trauma</a>,<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Lymphadenopathy" title="Lymphadenopathy">lymphadenitis</a> and, most commonly, calcified fecal deposits that are known as <a href="/wiki/Appendicolith" class="mw-redirect" title="Appendicolith">appendicoliths</a> or <a href="/wiki/Fecalith" title="Fecalith">fecaliths</a>.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:0_24-0" class="reference"><a href="#cite_note-:0-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> The occurrence of <a href="/wiki/Fecaloma" class="mw-redirect" title="Fecaloma">obstructing fecaliths</a> has attracted attention since their presence in people with appendicitis is higher in developed than in developing countries.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> In addition, an appendiceal fecalith is commonly associated with complicated appendicitis.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> Fecal stasis and arrest may play a role, as demonstrated by people with acute appendicitis having fewer bowel movements per week compared with healthy controls.<sup id="cite_ref-:0_24-1" class="reference"><a href="#cite_note-:0-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p><p>The occurrence of a fecalith in the appendix was thought to be attributed to a right-sided fecal retention reservoir in the colon and a prolonged transit time. However, a prolonged transit time was not observed in subsequent studies.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Diverticular_disease" title="Diverticular disease">Diverticular disease</a> and <a href="/wiki/Adenomatous_polyps" class="mw-redirect" title="Adenomatous polyps">adenomatous polyps</a> were historically unknown and <a href="/wiki/Colon_cancer" class="mw-redirect" title="Colon cancer">colon cancer</a> was exceedingly rare in communities where appendicitis itself was rare or absent, such as various African communities. Studies have implicated a transition to a <a href="/wiki/Western_diet" class="mw-redirect" title="Western diet">Western diet</a> lower in <a href="/wiki/Dietary_fiber" title="Dietary fiber">fiber</a> in rising frequencies of appendicitis as well as the other aforementioned colonic diseases in these communities.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> And acute appendicitis has been shown to occur antecedent to cancer in the colon and rectum.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> Several studies offer evidence that a low fiber intake is involved in the pathogenesis of appendicitis.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> This low intake of dietary fiber is in accordance with the occurrence of a right-sided fecal reservoir and the fact that dietary fiber reduces transit time.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=3" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="ImageStackPopup" data-imagestackpopup-config="[{"loop":false,"title":"","list":"User:Doc_James/Appendicitis_CT#medical","caption":"imagestackpopup-caption-0.51895429404404","start":177}]"><figure class="mw-default-size" typeof="mw:File/Thumb"><span><img resource="/wiki/File:Appendicitis_(CT_angiogram)_(Radiopaedia_154713-127660_Axial_1).jpg" src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e7/Appendicitis_%28CT_angiogram%29_%28Radiopaedia_154713-127660_Axial_1%29.jpg/290px-Appendicitis_%28CT_angiogram%29_%28Radiopaedia_154713-127660_Axial_1%29.jpg" decoding="async" width="290" height="274" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e7/Appendicitis_%28CT_angiogram%29_%28Radiopaedia_154713-127660_Axial_1%29.jpg/435px-Appendicitis_%28CT_angiogram%29_%28Radiopaedia_154713-127660_Axial_1%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e7/Appendicitis_%28CT_angiogram%29_%28Radiopaedia_154713-127660_Axial_1%29.jpg/580px-Appendicitis_%28CT_angiogram%29_%28Radiopaedia_154713-127660_Axial_1%29.jpg 2x" data-file-width="740" data-file-height="699" /></span><figcaption>CT scan showing acute appendicitis</figcaption></figure></div><div id="imagestackpopup-caption-0.51895429404404" style="display: none"><a href="/wiki/CT_scan" title="CT scan">CT scan</a> showing acute appendicitis</div> <p>The physician will ask questions to get the <a href="/wiki/Health_history" class="mw-redirect" title="Health history">health history</a>, assess the patient's <a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">symptoms</a>, do a complete <a href="/wiki/Physical_examination" title="Physical examination">physical exam</a>, and order both laboratory and imaging tests.<sup id="cite_ref-NIDDK_36-0" class="reference"><a href="#cite_note-NIDDK-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> Appendicitis symptoms fall into two categories, typical and atypical.<sup id="cite_ref-typical_37-0" class="reference"><a href="#cite_note-typical-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p><p>Typical appendicitis is characterized by a migratory right <a href="/wiki/Iliac_fossa" title="Iliac fossa">iliac fossa</a> pain associated with nausea, and anorexia, which can occur with or without vomiting and localized muscle stiffness/ generalized <a href="/wiki/Abdominal_guarding" title="Abdominal guarding">guarding</a>.<sup id="cite_ref-typical_37-1" class="reference"><a href="#cite_note-typical-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> It is possible the pain could localize to <a href="/wiki/Left_lower_quadrant" class="mw-redirect" title="Left lower quadrant">the left lower quadrant</a> in people with <a href="/wiki/Situs_inversus_totalis" class="mw-redirect" title="Situs inversus totalis">situs inversus totalis</a>.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> The combination of migrated <a href="/wiki/Umbilical_region" title="Umbilical region">umbilical</a> pain to the right <a href="/wiki/Quadrants_and_regions_of_abdomen" title="Quadrants and regions of abdomen">lower quadrant</a>, loss of appetite for food, nausea, unsustained <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, and mild <a href="/wiki/Fever" title="Fever">fever</a> is classic.<sup id="cite_ref-typical_37-2" class="reference"><a href="#cite_note-typical-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> </p><p>Atypical histories lack this typical progression and may include pain in the right lower quadrant as an initial symptom. Irritation of the peritoneum (inside lining of the abdominal wall) can lead to increased pain on movement, or jolting, for example going over <a href="/wiki/Speed_bump" title="Speed bump">speed bumps</a>.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> Atypical histories often require imaging with ultrasound or CT scanning.<sup id="cite_ref-Hob1998_3-3" class="reference"><a href="#cite_note-Hob1998-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Signs">Signs</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=4" title="Edit section: Signs"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>During the early stages of appendicitis diagnosis, it is common for <a href="/wiki/Physical_examination" title="Physical examination">physical exams</a> to present inconspicuous findings. Signs of inflammation become noticeable as the disease progresses. These signs may include<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> </p> <ul><li><a href="/wiki/Aure-Rozanova%27s_sign" title="Aure-Rozanova's sign">Aure-Rozanova's sign</a>: Increased pain on palpation with a finger in the right <a href="/wiki/Lumbar_triangle" title="Lumbar triangle">inferior lumbar triangle</a> (can be a positive <a href="/wiki/Blumberg%27s_sign" title="Blumberg's sign">Blumberg's sign</a>).<sup id="cite_ref-SachdevaDutta2012_41-0" class="reference"><a href="#cite_note-SachdevaDutta2012-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Bartomier-Michelson%27s_sign" title="Bartomier-Michelson's sign">Bartomier-Michelson's sign</a>: Increased pain on palpation at the right iliac region as the person being examined lies on their left side compared to when they lie on their back.<sup id="cite_ref-SachdevaDutta2012_41-1" class="reference"><a href="#cite_note-SachdevaDutta2012-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Dunphy%27s_sign" title="Dunphy's sign">Dunphy's sign</a>: Increased pain in the right lower quadrant by coughing.<sup id="cite_ref-Sign_42-0" class="reference"><a href="#cite_note-Sign-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hamburger_sign" title="Hamburger sign">Hamburger sign</a>: The patient refuses to eat (<a href="/wiki/Anorexia_(symptom)" title="Anorexia (symptom)">anorexia</a> is 80% <a href="/wiki/Sensitivity_and_specificity" title="Sensitivity and specificity">sensitive</a> for appendicitis)<sup id="cite_ref-VirgilioFrank2015_43-0" class="reference"><a href="#cite_note-VirgilioFrank2015-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup></li> <li><a href="/w/index.php?title=Kocher%27s_sign_(appendicitis)&action=edit&redlink=1" class="new" title="Kocher's sign (appendicitis) (page does not exist)">Kocher's sign</a> (Kosher's sign): From the person's medical history, the start of pain in the umbilical region with a subsequent shift to the right iliac region.<sup id="cite_ref-SachdevaDutta2012_41-2" class="reference"><a href="#cite_note-SachdevaDutta2012-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Massouh%27s_sign" title="Massouh's sign">Massouh's sign</a>: Developed in and popular in southwest England, the examiner performs a firm swish with their index and middle finger across the abdomen from the <a href="/wiki/Xiphoid_process" title="Xiphoid process">xiphoid process</a> to the left and the right iliac fossa.<sup id="cite_ref-Sign_42-1" class="reference"><a href="#cite_note-Sign-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Obturator_sign" title="Obturator sign">Obturator sign</a>: The person being evaluated lies on her or his back with the hip and knee both flexed at ninety degrees. The examiner holds the person's ankle with one hand and knee with the other hand. The examiner rotates the hip by moving the person's ankle away from their body while allowing the knee to move only inward. A positive test is pain with internal rotation of the hip.<sup id="cite_ref-WolfsonCloutier2014_44-0" class="reference"><a href="#cite_note-WolfsonCloutier2014-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Psoas_sign" title="Psoas sign">Psoas sign</a>, also known as "Obraztsova's sign", is right lower-quadrant pain that is produced with either the passive extension of the right hip or by the active flexion of the person's right hip while supine. The pain that is elicited is due to inflammation of the peritoneum overlying the iliopsoas muscles and inflammation of the psoas muscles themselves. Straightening out the leg causes pain because it stretches these muscles while flexing the hip activates the iliopsoas and causes pain.<sup id="cite_ref-WolfsonCloutier2014_44-1" class="reference"><a href="#cite_note-WolfsonCloutier2014-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Rovsing%27s_sign" title="Rovsing's sign">Rovsing's sign</a>: Pain in the lower right abdominal quadrant with continuous deep palpation starting from the left <a href="/wiki/Iliac_fossa" title="Iliac fossa">iliac fossa</a> upwards (counterclockwise along the colon). The thought is there will be increased pressure around the appendix by pushing bowel contents and air toward the <a href="/wiki/Ileocaecal_valve" class="mw-redirect" title="Ileocaecal valve">ileocaecal valve</a> provoking right-sided abdominal pain.<sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Rosenstein%27s_sign" title="Rosenstein's sign">Rosenstein's sign</a> (Sitkovsky's sign): Increased pain in the right iliac region as the person is being examined lies on their left side.<sup id="cite_ref-DunsterHunter1922_46-0" class="reference"><a href="#cite_note-DunsterHunter1922-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup></li> <li>Perman's sign: In acute appendicitis palpation in the left iliac fossa may produce pain in the right iliac fossa.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="Laboratory_tests">Laboratory tests</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=5" title="Edit section: Laboratory tests"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>While there is no laboratory test specific for appendicitis, a <a href="/wiki/Complete_blood_count" title="Complete blood count">complete blood count</a> (CBC) is done to check for signs of infection or inflammation. Although 70–90 percent of people with appendicitis may have an elevated <a href="/wiki/White_blood_cell_count" class="mw-redirect" title="White blood cell count">white blood cell (WBC) count</a>, many other abdominal and pelvic conditions can cause the WBC count to be elevated.<sup id="cite_ref-CDEM_48-0" class="reference"><a href="#cite_note-CDEM-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> However, a high <a href="/wiki/White_blood_cell_count" class="mw-redirect" title="White blood cell count">WBC count</a> may not alone represent a solid indicator of appendicitis but rather an inflammation<sup id="cite_ref-Shogilev2014_15-1" class="reference"><a href="#cite_note-Shogilev2014-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> but the neutrophil ratio was more sensitive and specific for acute appendicitis.<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> </p><p>In children, <a href="/wiki/Neutrophil_to_lymphocyte_ratio" title="Neutrophil to lymphocyte ratio">neutrophil-lymphocyte ratio (NLR)</a> demonstrates a high degree of accuracy in the diagnosis of acute appendicitis and distinguishes complicated appendicitis from simple appendicitis.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> 75–78 percent of the patients have <a href="/wiki/Neutrophilia" title="Neutrophilia">neutrophilia</a>.<sup id="cite_ref-Sign_42-2" class="reference"><a href="#cite_note-Sign-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Delta-neutrophil index (DNI) is a valuable parameter that helps in the diagnosis of histologically normal appendicitis and distinguishing between simple and complicated appendicitis.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> </p><p>A <a rel="nofollow" class="external text" href="https://medlineplus.gov/lab-tests/c-reactive-protein-crp-test/">C-reactive protein (CRP) blood test</a> will be ordered by the doctor to find out if there are any further causes of inflammation.<sup id="cite_ref-NIDDK_36-1" class="reference"><a href="#cite_note-NIDDK-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> The C-reactive protein/albumin (CRP/ALB) ratio can be a reliable predictor of complicated appendicitis.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> </p><p>The <a href="/wiki/Urinalysis" title="Urinalysis">urinalysis</a> is important for ruling out a urinary tract infection as the cause of abdominal pain. The presence of more than 20 WBC per high-power field in the urine is more suggestive of a urinary tract disorder.<sup id="cite_ref-CDEM_48-1" class="reference"><a href="#cite_note-CDEM-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> </p><p>If the patient is a female, a <a href="/wiki/Pregnancy_test" title="Pregnancy test">pregnancy test</a> will be ordered.<sup id="cite_ref-NIDDK_36-2" class="reference"><a href="#cite_note-NIDDK-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Imaging">Imaging</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=6" title="Edit section: Imaging"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In children, the clinical examination is important to determine which children with abdominal pain should receive immediate surgical consultation and which should receive diagnostic imaging.<sup id="cite_ref-pmid17652298_53-0" class="reference"><a href="#cite_note-pmid17652298-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> Because of the health risks of exposing children to radiation, ultrasound is the preferred first choice with CT scan being a legitimate follow-up if the ultrasound is inconclusive.<sup id="cite_ref-ACRfive_54-0" class="reference"><a href="#cite_note-ACRfive-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-effectiveusct_55-0" class="reference"><a href="#cite_note-effectiveusct-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-appendicitischildren_56-0" class="reference"><a href="#cite_note-appendicitischildren-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> CT scan is more accurate than ultrasound for the diagnosis of appendicitis in adults and adolescents. CT scan has a <a href="/wiki/Sensitivity_(tests)" class="mw-redirect" title="Sensitivity (tests)">sensitivity</a> of 94%, <a href="/wiki/Specificity_(tests)" class="mw-redirect" title="Specificity (tests)">specificity</a> of 95%. Ultrasonography had an overall <a href="/wiki/Sensitivity_(tests)" class="mw-redirect" title="Sensitivity (tests)">sensitivity</a> of 86%, a <a href="/wiki/Specificity_(tests)" class="mw-redirect" title="Specificity (tests)">specificity</a> of 81%.<sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Ultrasound">Ultrasound</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=7" title="Edit section: Ultrasound"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:SonoAppendizitis.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a9/SonoAppendizitis.JPG/220px-SonoAppendizitis.JPG" decoding="async" width="220" height="180" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a9/SonoAppendizitis.JPG/330px-SonoAppendizitis.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a9/SonoAppendizitis.JPG/440px-SonoAppendizitis.JPG 2x" data-file-width="696" data-file-height="568" /></a><figcaption>An <a href="/wiki/Ultrasound" title="Ultrasound">ultrasound</a> image of acute appendicitis in December 2008</figcaption></figure> <p><a href="/wiki/Abdominal_ultrasonography" title="Abdominal ultrasonography">Abdominal ultrasonography</a>, preferably with <a href="/wiki/Doppler_sonography" class="mw-redirect" title="Doppler sonography">doppler sonography</a>, is useful to detect appendicitis, especially in children. Ultrasound can show the free fluid collection in the right iliac fossa, along with a visible appendix with increased blood flow when using color Doppler, and noncompressibility of the appendix, as it is essentially a walled-off abscess. Other secondary sonographic signs of acute appendicitis include the presence of echogenic mesenteric fat surrounding the appendix and the acoustic shadowing of an appendicolith.<sup id="cite_ref-ReferenceA_58-0" class="reference"><a href="#cite_note-ReferenceA-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> In some cases (approximately 5%),<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> ultrasonography of the <a href="/wiki/Iliac_fossa" title="Iliac fossa">iliac fossa</a> does not reveal any abnormalities despite the presence of appendicitis. This false-negative finding is especially true of early appendicitis before the appendix has become significantly distended. Also, false-negative findings are more common in adults where larger amounts of fat and bowel gas make visualizing the appendix technically difficult. Despite these limitations, sonographic imaging with experienced hands can often distinguish between appendicitis and other diseases with similar symptoms. Some of these conditions include <a href="/wiki/Inflammation" title="Inflammation">inflammation</a> of <a href="/wiki/Lymph_nodes" class="mw-redirect" title="Lymph nodes">lymph nodes</a> near the appendix or pain originating from other pelvic organs such as the ovaries or Fallopian tubes. Ultrasounds may be either done by the radiology department or by the emergency physician.<sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> </p> <ul class="gallery mw-gallery-traditional"> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><span><video id="mwe_player_0" poster="//upload.wikimedia.org/wikipedia/commons/thumb/5/53/UOTW_45_-_Ultrasound_of_the_Week_1.webm/120px--UOTW_45_-_Ultrasound_of_the_Week_1.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="120" height="71" data-durationhint="12" data-mwtitle="UOTW_45_-_Ultrasound_of_the_Week_1.webm" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/5/53/UOTW_45_-_Ultrasound_of_the_Week_1.webm" type="video/webm; codecs="vp8"" data-width="792" data-height="470" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/5/53/UOTW_45_-_Ultrasound_of_the_Week_1.webm/UOTW_45_-_Ultrasound_of_the_Week_1.webm.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="404" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/5/53/UOTW_45_-_Ultrasound_of_the_Week_1.webm/UOTW_45_-_Ultrasound_of_the_Week_1.webm.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="606" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/5/53/UOTW_45_-_Ultrasound_of_the_Week_1.webm/UOTW_45_-_Ultrasound_of_the_Week_1.webm.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="606" data-height="360" /></video></span></span></div> <div class="gallerytext">Ultrasound showing appendicitis and an appendicolith<sup id="cite_ref-UOTW45_61-0" class="reference"><a href="#cite_note-UOTW45-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup></div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:UOTW_45_-_Ultrasound_of_the_Week_3.jpg" class="mw-file-description" title="Ultrasound showing appendicitis and an appendicolith[61]"><img alt="Ultrasound showing appendicitis and an appendicolith[61]" src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e0/UOTW_45_-_Ultrasound_of_the_Week_3.jpg/120px-UOTW_45_-_Ultrasound_of_the_Week_3.jpg" decoding="async" width="120" height="83" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e0/UOTW_45_-_Ultrasound_of_the_Week_3.jpg/180px-UOTW_45_-_Ultrasound_of_the_Week_3.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e0/UOTW_45_-_Ultrasound_of_the_Week_3.jpg/240px-UOTW_45_-_Ultrasound_of_the_Week_3.jpg 2x" data-file-width="680" data-file-height="470" /></a></span></div> <div class="gallerytext">Ultrasound showing appendicitis and an appendicolith<sup id="cite_ref-UOTW45_61-1" class="reference"><a href="#cite_note-UOTW45-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup></div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Ultrasonography_of_a_normal_appendix,_annotated.jpg" class="mw-file-description" title="Ultrasound of a normal appendix for comparison"><img alt="Ultrasound of a normal appendix for comparison" src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b6/Ultrasonography_of_a_normal_appendix%2C_annotated.jpg/120px-Ultrasonography_of_a_normal_appendix%2C_annotated.jpg" decoding="async" width="120" height="84" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b6/Ultrasonography_of_a_normal_appendix%2C_annotated.jpg/180px-Ultrasonography_of_a_normal_appendix%2C_annotated.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b6/Ultrasonography_of_a_normal_appendix%2C_annotated.jpg/240px-Ultrasonography_of_a_normal_appendix%2C_annotated.jpg 2x" data-file-width="1001" data-file-height="703" /></a></span></div> <div class="gallerytext">Ultrasound of a normal appendix for comparison</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Ultrasonography_of_a_normal_appendix_without_and_with_compression.jpg" class="mw-file-description" title="A normal appendix without and with compression. Absence of compressibility indicates appendicitis.[58]"><img alt="A normal appendix without and with compression. Absence of compressibility indicates appendicitis.[58]" src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Ultrasonography_of_a_normal_appendix_without_and_with_compression.jpg/120px-Ultrasonography_of_a_normal_appendix_without_and_with_compression.jpg" decoding="async" width="120" height="81" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Ultrasonography_of_a_normal_appendix_without_and_with_compression.jpg/180px-Ultrasonography_of_a_normal_appendix_without_and_with_compression.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Ultrasonography_of_a_normal_appendix_without_and_with_compression.jpg/240px-Ultrasonography_of_a_normal_appendix_without_and_with_compression.jpg 2x" data-file-width="343" data-file-height="232" /></a></span></div> <div class="gallerytext">A normal appendix without and with compression. Absence of compressibility indicates appendicitis.<sup id="cite_ref-ReferenceA_58-1" class="reference"><a href="#cite_note-ReferenceA-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup></div> </li> </ul> <div class="mw-heading mw-heading4"><h4 id="Computed_tomography">Computed tomography</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=8" title="Edit section: Computed tomography"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:CAT_scan_demonstrating_acute_appendicitis.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/7c/CAT_scan_demonstrating_acute_appendicitis.jpg/220px-CAT_scan_demonstrating_acute_appendicitis.jpg" decoding="async" width="220" height="155" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/7c/CAT_scan_demonstrating_acute_appendicitis.jpg/330px-CAT_scan_demonstrating_acute_appendicitis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/7c/CAT_scan_demonstrating_acute_appendicitis.jpg/440px-CAT_scan_demonstrating_acute_appendicitis.jpg 2x" data-file-width="986" data-file-height="695" /></a><figcaption>A CT scan demonstrating acute appendicitis (note the appendix has a diameter of 17.1 mm and there is surrounding fat stranding)</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:X-ray_showing_fecalith_which_has_caused_appendicitis.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/55/X-ray_showing_fecalith_which_has_caused_appendicitis.jpg/220px-X-ray_showing_fecalith_which_has_caused_appendicitis.jpg" decoding="async" width="220" height="159" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/55/X-ray_showing_fecalith_which_has_caused_appendicitis.jpg/330px-X-ray_showing_fecalith_which_has_caused_appendicitis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/55/X-ray_showing_fecalith_which_has_caused_appendicitis.jpg/440px-X-ray_showing_fecalith_which_has_caused_appendicitis.jpg 2x" data-file-width="973" data-file-height="703" /></a><figcaption>A <a href="/wiki/Fecalith" title="Fecalith">fecalith</a> marked by the arrow that has resulted in acute appendicitis.</figcaption></figure> <p>Where it is readily available, <a href="/wiki/Computed_tomography" class="mw-redirect" title="Computed tomography">computed tomography</a> (CT) has become frequently used, especially in people whose diagnosis is not obvious on history and physical examination. Although some concerns about interpretation are identified, a 2019 Cochrane review found that the sensitivity and specificity of CT for the diagnosis of acute appendicitis in adults was high.<sup id="cite_ref-62" class="reference"><a href="#cite_note-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> Concerns about radiation tend to limit use of CT in pregnant women and in children, especially with the increasingly widespread usage of MRI.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup> </p><p>The accurate diagnosis of appendicitis is multi-tiered, with the size of the appendix having the strongest <a href="/wiki/Positive_predictive_value" class="mw-redirect" title="Positive predictive value">positive predictive value</a>, while indirect features can either increase or decrease sensitivity and specificity. A size of over 6 mm is both 95% sensitive and specific for appendicitis.<sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup> </p><p>However, because the appendix can be filled with fecal material, causing intraluminal distention, this criterion has shown limited utility in more recent meta-analyses.<sup id="cite_ref-plumpy1_66-0" class="reference"><a href="#cite_note-plumpy1-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> This is as opposed to ultrasound, in which the wall of the appendix can be more easily distinguished from intraluminal feces. In such scenarios, ancillary features such as increased wall enhancement as compared to adjacent bowel and inflammation of the surrounding fat, or fat stranding, can be supportive of the diagnosis. However, their absence does not preclude it. In severe cases with perforation, an adjacent <a href="/wiki/Phlegmon" title="Phlegmon">phlegmon</a> or <a href="/wiki/Abscess" title="Abscess">abscess</a> can be seen. Dense fluid layering in the pelvis can also result, related to either <a href="/wiki/Pus" title="Pus">pus</a> or <a href="/wiki/Feces" title="Feces">enteric spillage</a>. When patients are thin or younger, the relative absence of fat can make the appendix and surrounding fat stranding difficult to see.<sup id="cite_ref-plumpy1_66-1" class="reference"><a href="#cite_note-plumpy1-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Magnetic_resonance_imaging">Magnetic resonance imaging</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=9" title="Edit section: Magnetic resonance imaging"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Magnetic_resonance_imaging" title="Magnetic resonance imaging">Magnetic resonance imaging</a> (MRI) use has become increasingly common for diagnosis of appendicitis in children and pregnant patients due to the radiation dosage that, while of nearly negligible risk in healthy adults, can be harmful to children or the developing baby.<sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup> In pregnancy, it is more useful during the second and third trimester, particularly as the enlargening uterus displaces the appendix, making it difficult to find by ultrasound. The periappendiceal stranding that is reflected on CT by fat stranding on MRI appears as an increased fluid signal on T2 weighted sequences. First-trimester pregnancies are usually not candidates for MRI, as the fetus is still undergoing <a href="/wiki/Organogenesis" title="Organogenesis">organogenesis</a>, and there are no long-term studies to date regarding its potential risks or side effects.<sup id="cite_ref-68" class="reference"><a href="#cite_note-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="X-ray">X-ray</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=10" title="Edit section: X-ray"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:AppendicolithPlainXray.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2d/AppendicolithPlainXray.png/220px-AppendicolithPlainXray.png" decoding="async" width="220" height="194" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2d/AppendicolithPlainXray.png/330px-AppendicolithPlainXray.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2d/AppendicolithPlainXray.png/440px-AppendicolithPlainXray.png 2x" data-file-width="876" data-file-height="774" /></a><figcaption>Appendicolith as seen on plain X-ray</figcaption></figure> <p>In general, plain abdominal radiography (PAR) is not useful in making the diagnosis of appendicitis and should not be routinely obtained from a person being evaluated for appendicitis.<sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-70" class="reference"><a href="#cite_note-70"><span class="cite-bracket">[</span>70<span class="cite-bracket">]</span></a></sup> Plain abdominal films may be useful for the detection of <a href="/wiki/Ureter" title="Ureter">ureteral</a> <a href="/wiki/Calculus_(medicine)" title="Calculus (medicine)">calculi</a>, <a href="/wiki/Small_bowel_obstruction" class="mw-redirect" title="Small bowel obstruction">small bowel obstruction</a>, or <a href="/wiki/Perforated_ulcer" title="Perforated ulcer">perforated ulcer</a>, but these conditions are rarely confused with appendicitis.<sup id="cite_ref-Sabiston_71-0" class="reference"><a href="#cite_note-Sabiston-71"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup> An opaque <a href="/wiki/Fecalith" title="Fecalith">fecalith</a> can be identified in the right lower quadrant in fewer than 5% of people being evaluated for appendicitis.<sup id="cite_ref-CDEM_48-2" class="reference"><a href="#cite_note-CDEM-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> A <a href="/wiki/Barium_enema" class="mw-redirect" title="Barium enema">barium enema</a> has proven to be a poor diagnostic tool for appendicitis. While failure of the appendix to fill during a barium enema has been associated with appendicitis, up to 20% of normal appendices do not fill.<sup id="cite_ref-Sabiston_71-1" class="reference"><a href="#cite_note-Sabiston-71"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Scoring_systems">Scoring systems</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=11" title="Edit section: Scoring systems"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Several scoring systems have been developed to try to identify people who are likely to have appendicitis.<sup id="cite_ref-72" class="reference"><a href="#cite_note-72"><span class="cite-bracket">[</span>72<span class="cite-bracket">]</span></a></sup> The performance of scores such as the <a href="/wiki/Alvarado_score" title="Alvarado score">Alvarado score</a> and the Pediatric Appendicitis Score, however, are variable.<sup id="cite_ref-Kul2013_73-0" class="reference"><a href="#cite_note-Kul2013-73"><span class="cite-bracket">[</span>73<span class="cite-bracket">]</span></a></sup> </p><p>The Alvarado score is the most known scoring system. A score below 5 suggests against a diagnosis of appendicitis, whereas a score of 7 or more is predictive of acute appendicitis. In a person with an equivocal score of 5 or 6, a CT scan or ultrasound exam may be used to reduce the rate of negative appendectomy. </p> <table class="wikitable" style="margin-left:15px; text-align:center"> <caption>Alvarado score </caption> <tbody><tr> <td>Migratory right <a href="/wiki/Iliac_fossa" title="Iliac fossa">iliac fossa</a> pain </td> <td>1 point </td></tr> <tr> <td><a href="/wiki/Anorexia_(symptom)" title="Anorexia (symptom)">Anorexia</a> </td> <td>1 point </td></tr> <tr> <td><a href="/wiki/Nausea" title="Nausea">Nausea</a> and <a href="/wiki/Vomiting" title="Vomiting">vomiting</a> </td> <td>1 point </td></tr> <tr> <td>Right iliac fossa <a href="/wiki/Tenderness_(medicine)" title="Tenderness (medicine)">tenderness</a> </td> <td>2 points </td></tr> <tr> <td><a href="/wiki/Blumberg%27s_sign" title="Blumberg's sign">Rebound abdominal tenderness</a> </td> <td>1 point </td></tr> <tr> <td><a href="/wiki/Fever" title="Fever">Fever</a> </td> <td>1 point </td></tr> <tr> <td>High white blood cell count (<a href="/wiki/Leukocytosis" title="Leukocytosis">leukocytosis</a>) </td> <td>2 points </td></tr> <tr> <td>Shift to left (segmented <a href="/wiki/Neutrophils" class="mw-redirect" title="Neutrophils">neutrophils</a>) </td> <td>1 point </td></tr> <tr> <th>Total score </th> <th>10 points </th></tr></tbody></table> <div class="mw-heading mw-heading3"><h3 id="Pathology">Pathology</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=12" title="Edit section: Pathology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Even for clinically certain appendicitis, routine <a href="/wiki/Histopathology" title="Histopathology">histopathology</a> examination of appendectomy specimens is of value for identifying unsuspected pathologies requiring further postoperative management.<sup id="cite_ref-Abd_Al-Fatah2017_74-0" class="reference"><a href="#cite_note-Abd_Al-Fatah2017-74"><span class="cite-bracket">[</span>74<span class="cite-bracket">]</span></a></sup> Notably, <a href="/wiki/Appendix_cancer" title="Appendix cancer">appendix cancer</a> is found incidentally in about 1% of appendectomy specimens.<sup id="cite_ref-LeeChoi2011_75-0" class="reference"><a href="#cite_note-LeeChoi2011-75"><span class="cite-bracket">[</span>75<span class="cite-bracket">]</span></a></sup> </p><p>Pathology diagnosis of appendicitis can be made by detecting a <a href="/wiki/Neutrophil" title="Neutrophil">neutrophilic</a> infiltrate of the <a href="/wiki/Muscularis_propria" class="mw-redirect" title="Muscularis propria">muscularis propria</a>. </p><p>Periappendicitis (inflammation of tissues around the appendix) is often found in conjunction with other abdominal pathology.<sup id="cite_ref-pmid2349982_76-0" class="reference"><a href="#cite_note-pmid2349982-76"><span class="cite-bracket">[</span>76<span class="cite-bracket">]</span></a></sup> </p> <ul class="gallery mw-gallery-traditional"> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Appendicitis_-_low_mag.jpg" class="mw-file-description" title="Micrograph of appendicitis and periappendicitis. H&E stain"><img alt="Micrograph of appendicitis and periappendicitis. H&E stain" src="//upload.wikimedia.org/wikipedia/commons/thumb/5/50/Appendicitis_-_low_mag.jpg/120px-Appendicitis_-_low_mag.jpg" decoding="async" width="120" height="80" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/50/Appendicitis_-_low_mag.jpg/180px-Appendicitis_-_low_mag.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/50/Appendicitis_-_low_mag.jpg/240px-Appendicitis_-_low_mag.jpg 2x" data-file-width="4272" data-file-height="2848" /></a></span></div> <div class="gallerytext"><a href="/wiki/Micrograph" title="Micrograph">Micrograph</a> of appendicitis and periappendicitis. <a href="/wiki/H%26E_stain" title="H&E stain">H&E stain</a></div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Acute_appendicitis_High_Power.jpg" class="mw-file-description" title="Micrograph of appendicitis showing neutrophils in the muscularis propria. H&E stain"><img alt="Micrograph of appendicitis showing neutrophils in the muscularis propria. H&E stain" src="//upload.wikimedia.org/wikipedia/commons/thumb/8/8d/Acute_appendicitis_High_Power.jpg/120px-Acute_appendicitis_High_Power.jpg" decoding="async" width="120" height="90" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/8d/Acute_appendicitis_High_Power.jpg/180px-Acute_appendicitis_High_Power.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/8d/Acute_appendicitis_High_Power.jpg/240px-Acute_appendicitis_High_Power.jpg 2x" data-file-width="1024" data-file-height="768" /></a></span></div> <div class="gallerytext">Micrograph of appendicitis showing neutrophils in the muscularis propria. H&E stain</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Acute_suppurative_appendicitis_with_perforation.jpg" class="mw-file-description" title="Acute suppurative appendicitis with perforation (at right). H&E stain"><img alt="Acute suppurative appendicitis with perforation (at right). H&E stain" src="//upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Acute_suppurative_appendicitis_with_perforation.jpg/114px-Acute_suppurative_appendicitis_with_perforation.jpg" decoding="async" width="114" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Acute_suppurative_appendicitis_with_perforation.jpg/170px-Acute_suppurative_appendicitis_with_perforation.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Acute_suppurative_appendicitis_with_perforation.jpg/227px-Acute_suppurative_appendicitis_with_perforation.jpg 2x" data-file-width="2941" data-file-height="3105" /></a></span></div> <div class="gallerytext">Acute suppurative appendicitis with perforation (at right). H&E stain</div> </li> </ul> <table class="wikitable"> <caption>Classification of acute appendicitis based on <a href="/wiki/Gross_pathology" title="Gross pathology">gross pathology</a> and <a href="/wiki/Light_microscopy" class="mw-redirect" title="Light microscopy">light microscopy</a> characteristics<sup id="cite_ref-Carr2000_77-0" class="reference"><a href="#cite_note-Carr2000-77"><span class="cite-bracket">[</span>77<span class="cite-bracket">]</span></a></sup> </caption> <tbody><tr> <th>Pattern</th> <th>Gross pathology</th> <th>Light microscopy</th> <th>Image</th> <th>Clinical significance </th></tr> <tr> <th>Acute intraluminal inflammation </th> <td>None visible</td> <td> <ul><li>Only neutrophils in the lumen</li> <li>No ulceration or transmural inflammation</li></ul> </td> <td><span typeof="mw:File"><a href="/wiki/File:Histopathology_of_acute_intraluminal_inflammation_of_the_appendix.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/21/Histopathology_of_acute_intraluminal_inflammation_of_the_appendix.jpg/190px-Histopathology_of_acute_intraluminal_inflammation_of_the_appendix.jpg" decoding="async" width="190" height="142" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/21/Histopathology_of_acute_intraluminal_inflammation_of_the_appendix.jpg/285px-Histopathology_of_acute_intraluminal_inflammation_of_the_appendix.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/21/Histopathology_of_acute_intraluminal_inflammation_of_the_appendix.jpg/380px-Histopathology_of_acute_intraluminal_inflammation_of_the_appendix.jpg 2x" data-file-width="2048" data-file-height="1532" /></a></span> </td> <td>Probably none </td></tr> <tr> <th>Acuta mucosal inflammation </th> <td>None visible</td> <td> <ul><li>Neutrophils within the mucosa, and possibly in the submucosa</li> <li>Mucosal ulceration</li></ul> </td> <td> </td> <td>May be secondary to <a href="/wiki/Enteritis" title="Enteritis">enteritis</a>. </td></tr> <tr> <th>Suppurative acute appendicitis </th> <td>May be inapparent. <ul><li>Dull mucosa</li> <li>Congested surface vessels</li> <li>Fibropurulent serosal exudate in late cases</li> <li>Dilated appendix</li></ul> </td> <td> <ul><li>Neutrophils in the mucosa, submucosa, and muscularis propria, potentially transmural.</li> <li>Extensive inflammation</li> <li>Commonly intramural abscesses</li> <li>Possibly vascular thrombosis</li></ul> </td> <td><span typeof="mw:File"><a href="/wiki/File:Acute_suppurative_appendicitis_with_perforation.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Acute_suppurative_appendicitis_with_perforation.jpg/190px-Acute_suppurative_appendicitis_with_perforation.jpg" decoding="async" width="190" height="201" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Acute_suppurative_appendicitis_with_perforation.jpg/285px-Acute_suppurative_appendicitis_with_perforation.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/5d/Acute_suppurative_appendicitis_with_perforation.jpg/380px-Acute_suppurative_appendicitis_with_perforation.jpg 2x" data-file-width="2941" data-file-height="3105" /></a></span> </td> <td>Can be presumed to be the primary cause of symptoms </td></tr> <tr> <th>Gangrenous/necrotizing appendicitis </th> <td> <ul><li>Friable wall</li> <li>Purple, green, or black color</li></ul> </td> <td> <ul><li>Transmural inflammation, obliterating normal histological structures</li> <li>Necrotic areas</li> <li>Extensive mucosal ulceration</li></ul> </td> <td><span typeof="mw:File"><a href="/wiki/File:Histopathology_of_necrotizing_appendicitis,_high_magnification.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/Histopathology_of_necrotizing_appendicitis%2C_high_magnification.jpg/190px-Histopathology_of_necrotizing_appendicitis%2C_high_magnification.jpg" decoding="async" width="190" height="142" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a2/Histopathology_of_necrotizing_appendicitis%2C_high_magnification.jpg/285px-Histopathology_of_necrotizing_appendicitis%2C_high_magnification.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a2/Histopathology_of_necrotizing_appendicitis%2C_high_magnification.jpg/380px-Histopathology_of_necrotizing_appendicitis%2C_high_magnification.jpg 2x" data-file-width="2048" data-file-height="1532" /></a></span> </td> <td>Will perforate if untreated </td></tr> <tr> <th>Periappendicitis </th> <td>May be inapparent. <ul><li>Serosa may be congested, dull, and exudative</li></ul> </td> <td> <ul><li>Serosal and subserosal inflammation, no further than outer muscularis propria to be called isolated</li></ul> </td> <td><span typeof="mw:File"><a href="/wiki/File:Histopathology_of_periappendicitis.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a5/Histopathology_of_periappendicitis.jpg/190px-Histopathology_of_periappendicitis.jpg" decoding="async" width="190" height="115" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a5/Histopathology_of_periappendicitis.jpg/285px-Histopathology_of_periappendicitis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a5/Histopathology_of_periappendicitis.jpg/380px-Histopathology_of_periappendicitis.jpg 2x" data-file-width="3889" data-file-height="2353" /></a></span> </td> <td>If isolated, probably secondary to other disease </td></tr> <tr> <th>Eosinophilic appendicitis </th> <td>None visible </td> <td> <ul><li>>10 eosinophils/mm<sup>2</sup> in muscularis propria.</li> <li>No changes conforming to other types of appendicitis</li></ul> </td> <td> </td> <td>Possibly parasitic, or eosinophilic enteritis. </td></tr></tbody></table> <div class="mw-heading mw-heading3"><h3 id="Differential_diagnosis">Differential diagnosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=13" title="Edit section: Differential diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Enlarged_gallbladder_with_gallstone_and_cholecystitis.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b3/Enlarged_gallbladder_with_gallstone_and_cholecystitis.jpg/220px-Enlarged_gallbladder_with_gallstone_and_cholecystitis.jpg" decoding="async" width="220" height="232" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b3/Enlarged_gallbladder_with_gallstone_and_cholecystitis.jpg/330px-Enlarged_gallbladder_with_gallstone_and_cholecystitis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b3/Enlarged_gallbladder_with_gallstone_and_cholecystitis.jpg/440px-Enlarged_gallbladder_with_gallstone_and_cholecystitis.jpg 2x" data-file-width="893" data-file-height="940" /></a><figcaption><a href="/wiki/Coronal_plane" title="Coronal plane">Coronal</a> <a href="/wiki/CT_scan" title="CT scan">CT scan</a> of a person initially suspected of having appendicitis because of right-sided pain. The CT shows in fact an enlarged <a href="/wiki/Cholecystitis" title="Cholecystitis">inflamed gallbladder</a> that reaches the right lower part of the abdomen.</figcaption></figure> <p>Children: <a href="/wiki/Gastroenteritis" title="Gastroenteritis">Gastroenteritis</a>, <a href="/wiki/Mesenteric_adenitis" class="mw-redirect" title="Mesenteric adenitis">mesenteric adenitis</a>, <a href="/wiki/Meckel%27s_diverticulum" title="Meckel's diverticulum">Meckel's diverticulitis</a>, <a href="/wiki/Intussusception_(medical_disorder)" title="Intussusception (medical disorder)">intussusception</a>, <a href="/wiki/Henoch%E2%80%93Sch%C3%B6nlein_purpura" title="Henoch–Schönlein purpura">Henoch–Schönlein purpura</a>, lobar <a href="/wiki/Pneumonia" title="Pneumonia">pneumonia</a>, <a href="/wiki/Urinary_tract_infection" title="Urinary tract infection">urinary tract infection</a> (abdominal pain in the absence of other symptoms can occur in children with UTI), new-onset <a href="/wiki/Crohn%27s_disease" title="Crohn's disease">Crohn's disease</a> or <a href="/wiki/Ulcerative_colitis" title="Ulcerative colitis">ulcerative colitis</a>, <a href="/wiki/Pancreatitis" title="Pancreatitis">pancreatitis</a>, and abdominal trauma from <a href="/wiki/Child_abuse" title="Child abuse">child abuse</a>; <a href="/wiki/Distal_intestinal_obstruction_syndrome" title="Distal intestinal obstruction syndrome">distal intestinal obstruction syndrome</a> in children with cystic fibrosis; <a href="/wiki/Typhlitis" class="mw-redirect" title="Typhlitis">typhlitis</a> in children with leukemia. </p><p>Women: A pregnancy test is important for all women of childbearing age since an <a href="/wiki/Ectopic_pregnancy" title="Ectopic pregnancy">ectopic pregnancy</a> can have signs and symptoms similar to those of appendicitis. Other obstetrical/ gynecological causes of similar abdominal pain in women include <a href="/wiki/Pelvic_inflammatory_disease" title="Pelvic inflammatory disease">pelvic inflammatory disease</a>, <a href="/wiki/Ovarian_torsion" title="Ovarian torsion">ovarian torsion</a>, <a href="/wiki/Menarche" title="Menarche">menarche</a>, dysmenorrhea, <a href="/wiki/Endometriosis" title="Endometriosis">endometriosis</a>, and <a href="/wiki/Mittelschmerz" title="Mittelschmerz">Mittelschmerz</a> (the passing of an egg in the ovaries approximately two weeks before menstruation).<sup id="cite_ref-78" class="reference"><a href="#cite_note-78"><span class="cite-bracket">[</span>78<span class="cite-bracket">]</span></a></sup> </p><p>Men: <a href="/wiki/Testicular_torsion" title="Testicular torsion">testicular torsion</a> </p><p>Adults: new-onset <a href="/wiki/Crohn_disease" class="mw-redirect" title="Crohn disease">Crohn disease</a>, <a href="/wiki/Ulcerative_colitis" title="Ulcerative colitis">ulcerative colitis</a>, regional enteritis, <a href="/wiki/Cholecystitis" title="Cholecystitis">cholecystitis</a>, <a href="/wiki/Renal_colic" title="Renal colic">renal colic</a>, perforated <a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">peptic ulcer</a>, <a href="/wiki/Pancreatitis" title="Pancreatitis">pancreatitis</a>, <a href="/wiki/Rectus_sheath_hematoma" title="Rectus sheath hematoma">rectus sheath hematoma</a> and <a href="/wiki/Epiploic_appendagitis" title="Epiploic appendagitis">epiploic appendagitis</a>. </p><p>Elderly: <a href="/wiki/Diverticulitis" title="Diverticulitis">diverticulitis</a>, intestinal obstruction, <a href="/wiki/Colon_cancer" class="mw-redirect" title="Colon cancer">colonic carcinoma</a>, <a href="/wiki/Mesenteric_ischemia" class="mw-redirect" title="Mesenteric ischemia">mesenteric ischemia</a>, leaking <a href="/wiki/Aortic_aneurysm" title="Aortic aneurysm">aortic aneurysm</a>. </p><p>The term "<style data-mw-deduplicate="TemplateStyles:r1238216509">.mw-parser-output .vanchor>:target~.vanchor-text{background-color:#b1d2ff}@media screen{html.skin-theme-clientpref-night .mw-parser-output .vanchor>:target~.vanchor-text{background-color:#0f4dc9}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .vanchor>:target~.vanchor-text{background-color:#0f4dc9}}</style><span class="vanchor"><span id="pseudoappendicitis"></span><span class="vanchor-text">pseudoappendicitis</span></span>" is used to describe a condition mimicking appendicitis.<sup id="cite_ref-pmid20633930_79-0" class="reference"><a href="#cite_note-pmid20633930-79"><span class="cite-bracket">[</span>79<span class="cite-bracket">]</span></a></sup> It can be associated with <i><a href="/wiki/Yersinia_enterocolitica" title="Yersinia enterocolitica">Yersinia enterocolitica</a></i>.<sup id="cite_ref-pmid18575909_80-0" class="reference"><a href="#cite_note-pmid18575909-80"><span class="cite-bracket">[</span>80<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=14" title="Edit section: Management"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Acute appendicitis<sup id="cite_ref-81" class="reference"><a href="#cite_note-81"><span class="cite-bracket">[</span>81<span class="cite-bracket">]</span></a></sup> is typically managed by <a href="/wiki/Surgery" title="Surgery">surgery</a>. While antibiotics are safe and effective for treating uncomplicated appendicitis,<sup id="cite_ref-BJS_paper_16-1" class="reference"><a href="#cite_note-BJS_paper-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Antibiotics2012_7-2" class="reference"><a href="#cite_note-Antibiotics2012-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-82" class="reference"><a href="#cite_note-82"><span class="cite-bracket">[</span>82<span class="cite-bracket">]</span></a></sup> 31% of people had a recurrence within a year and required an eventual appendectomy.<sup id="cite_ref-ReferenceB_18-1" class="reference"><a href="#cite_note-ReferenceB-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Antibiotics are less effective if an <a href="/wiki/Appendicolith" class="mw-redirect" title="Appendicolith">appendicolith</a> is present.<sup id="cite_ref-83" class="reference"><a href="#cite_note-83"><span class="cite-bracket">[</span>83<span class="cite-bracket">]</span></a></sup> While 51% of patients who were treated with antibiotics did not need an appendectomy three years after treatment,<sup id="cite_ref-84" class="reference"><a href="#cite_note-84"><span class="cite-bracket">[</span>84<span class="cite-bracket">]</span></a></sup> the cost effectiveness of surgery versus antibiotics is unclear<sup id="cite_ref-85" class="reference"><a href="#cite_note-85"><span class="cite-bracket">[</span>85<span class="cite-bracket">]</span></a></sup> </p><p>Using antibiotics to prevent potential postoperative complications in emergency appendectomy procedures is recommended, and the antibiotics are effective when given to a person before, during, or after surgery.<sup id="cite_ref-86" class="reference"><a href="#cite_note-86"><span class="cite-bracket">[</span>86<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Pain">Pain</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=15" title="Edit section: Pain"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Pain medications (such as <a href="/wiki/Morphine" title="Morphine">morphine</a>) do not appear to affect the accuracy of the clinical diagnosis of appendicitis and therefore should be given early in the patient's care.<sup id="cite_ref-And2008_87-0" class="reference"><a href="#cite_note-And2008-87"><span class="cite-bracket">[</span>87<span class="cite-bracket">]</span></a></sup> Historically there were concerns among some general surgeons that analgesics would affect the clinical exam in children, and some recommended that they not be given until the surgeon was able to examine the person.<sup id="cite_ref-And2008_87-1" class="reference"><a href="#cite_note-And2008-87"><span class="cite-bracket">[</span>87<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=16" title="Edit section: Surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Appendectomy" title="Appendectomy">Appendectomy</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Apendixexternalview.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a1/Apendixexternalview.jpg/220px-Apendixexternalview.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a1/Apendixexternalview.jpg/330px-Apendixexternalview.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a1/Apendixexternalview.jpg/440px-Apendixexternalview.jpg 2x" data-file-width="4000" data-file-height="3000" /></a><figcaption>Inflamed appendix removal by open surgery</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Appendix-Entfernung.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b0/Appendix-Entfernung.jpg/220px-Appendix-Entfernung.jpg" decoding="async" width="220" height="161" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b0/Appendix-Entfernung.jpg/330px-Appendix-Entfernung.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b0/Appendix-Entfernung.jpg/440px-Appendix-Entfernung.jpg 2x" data-file-width="796" data-file-height="584" /></a><figcaption>Laparoscopic appendectomy.</figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Lap_apendix.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f0/Lap_apendix.jpg/220px-Lap_apendix.jpg" decoding="async" width="220" height="124" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f0/Lap_apendix.jpg/330px-Lap_apendix.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f0/Lap_apendix.jpg/440px-Lap_apendix.jpg 2x" data-file-width="1920" data-file-height="1080" /></a><figcaption>Laparoscopic view of a phlegmonous cecal appendix with fibrinous plaques, located in the right iliac fossa.</figcaption></figure> <p>The <a href="/wiki/Surgery" title="Surgery">surgical</a> procedure for the removal of the appendix is called an <a href="/wiki/Appendectomy" title="Appendectomy">appendectomy</a>. Appendectomy can be performed through open or laparoscopic surgery. Laparoscopic appendectomy has several advantages over open appendectomy as an intervention for acute appendicitis.<sup id="cite_ref-88" class="reference"><a href="#cite_note-88"><span class="cite-bracket">[</span>88<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Open_appendectomy">Open appendectomy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=17" title="Edit section: Open appendectomy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>For over a century, laparotomy (open appendectomy) was the standard treatment for acute appendicitis.<sup id="cite_ref-89" class="reference"><a href="#cite_note-89"><span class="cite-bracket">[</span>89<span class="cite-bracket">]</span></a></sup> This procedure consists of the removal of the infected appendix through a single large incision in the lower right area of the abdomen.<sup id="cite_ref-90" class="reference"><a href="#cite_note-90"><span class="cite-bracket">[</span>90<span class="cite-bracket">]</span></a></sup> The incision in a laparotomy is usually 2 to 3 inches (51 to 76 mm) long. </p><p>During an open appendectomy, the person with suspected appendicitis is placed under general <a href="/wiki/Anesthesia" title="Anesthesia">anesthesia</a> to keep the muscles completely relaxed and to keep the person unconscious. The incision is two to three inches (76 mm) long, and it is made in the right lower abdomen, several inches above the <a href="/wiki/Hip_bone" title="Hip bone">hip bone</a>. Once the incision opens the abdomen cavity, and the appendix is identified, the <a href="/wiki/Surgeon" title="Surgeon">surgeon</a> removes the infected tissue and cuts the appendix from the surrounding tissue. After careful and close inspection of the infected area, and ensuring there are no signs that surrounding tissues are damaged or infected. In case of complicated appendicitis managed by an emergency open appendectomy, abdominal drainage (a temporary tube from the abdomen to the outside to avoid abscess formation) may be inserted, but this may increase the hospital stay.<sup id="cite_ref-91" class="reference"><a href="#cite_note-91"><span class="cite-bracket">[</span>91<span class="cite-bracket">]</span></a></sup><sup class="noprint Inline-Template" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers"><span title="Updated version https://www.ncbi.nlm.nih.gov/pubmed/34402522 (October 2021)">needs update</span></a></i>]</sup> The surgeon will start closing the incision. This means sewing the muscles and using <a href="/wiki/Surgical_staple" title="Surgical staple">surgical staples</a> or <a href="/wiki/Surgical_suture" title="Surgical suture">stitches</a> to close the skin up. To prevent infections, the incision is covered with a <a href="/wiki/Dressing_(medical)" class="mw-redirect" title="Dressing (medical)">sterile bandage</a> or surgical adhesive. </p> <div class="mw-heading mw-heading4"><h4 id="Laparoscopic_appendectomy">Laparoscopic appendectomy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=18" title="Edit section: Laparoscopic appendectomy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Laparoscopic appendectomy was introduced in 1983 and has become an increasingly prevalent intervention for acute appendicitis.<sup id="cite_ref-92" class="reference"><a href="#cite_note-92"><span class="cite-bracket">[</span>92<span class="cite-bracket">]</span></a></sup> This surgical procedure consists of making three to four incisions in the abdomen, each 0.25 to 0.5 inches (6.4 to 12.7 mm) long. This type of appendectomy is made by inserting a special surgical tool called a laparoscope into one of the incisions. The laparoscope is connected to a monitor outside the person's body, and it is designed to help the surgeon inspect the infected area in the abdomen. The other two incisions are made for the specific removal of the appendix by using <a href="/wiki/Surgical_instrument" title="Surgical instrument">surgical instruments</a>. Laparoscopic surgery requires <a href="/wiki/General_anesthesia" class="mw-redirect" title="General anesthesia">general anesthesia</a>, and it can last up to two hours. Laparoscopic appendectomy has several advantages over open appendectomy, including a shorter post-operative recovery, less post-operative pain, and a lower superficial surgical site infection rate. However, the occurrence of an intra-abdominal abscess is almost three times more prevalent in laparoscopic appendectomy than open appendectomy.<sup id="cite_ref-93" class="reference"><a href="#cite_note-93"><span class="cite-bracket">[</span>93<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Laparoscopic-assisted_transumbilical_appendectomy">Laparoscopic-assisted transumbilical appendectomy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=19" title="Edit section: Laparoscopic-assisted transumbilical appendectomy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In pediatric patients, the high mobility of the cecum allows externalization of the appendix through the umbilicus, and the entire procedure can be performed with a single incision. Laparoscopic-assisted transumbilical appendectomy is a relatively recent technique but with a long published series and very good surgical and aesthetic results.<sup id="cite_ref-94" class="reference"><a href="#cite_note-94"><span class="cite-bracket">[</span>94<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Pre-surgery">Pre-surgery</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=20" title="Edit section: Pre-surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The treatment begins by <a href="/wiki/Nil_per_os" class="mw-redirect" title="Nil per os">keeping the person who will be having surgery from eating or drinking</a> for a given period, usually overnight. An <a href="/wiki/Intravenous_therapy" title="Intravenous therapy">intravenous drip</a> is used to hydrate the person who will be having surgery. <a href="/wiki/Antibiotic" title="Antibiotic">Antibiotics</a> given intravenously such as <a href="/wiki/Cefuroxime" title="Cefuroxime">cefuroxime</a> and <a href="/wiki/Metronidazole" title="Metronidazole">metronidazole</a> may be administered early to help kill bacteria and thus reduce the spread of infection in the abdomen and postoperative complications in the abdomen or wound. Equivocal cases may become more difficult to assess with antibiotic treatment and benefit from serial examinations. If the stomach is empty (no food in the past six hours), general anaesthesia is usually used. Otherwise, <a href="/wiki/Spinal_anaesthesia" title="Spinal anaesthesia">spinal anaesthesia</a> may be used. </p><p>Once the decision to perform an <a href="/wiki/Appendectomy" title="Appendectomy">appendectomy</a> has been made, the preparation procedure takes approximately one to two hours. Meanwhile, the surgeon will explain the surgery procedure and will present the risks that must be considered when performing an appendectomy. (With all surgeries there are risks that must be evaluated before performing the procedures.) The risks are different depending on the state of the appendix. If the appendix has not ruptured, the complication rate is only about 3% but if the appendix has ruptured, the complication rate rises to almost 59%.<sup id="cite_ref-95" class="reference"><a href="#cite_note-95"><span class="cite-bracket">[</span>95<span class="cite-bracket">]</span></a></sup> The most usual complications that can occur are pneumonia, <a href="/wiki/Hernia" title="Hernia">hernia</a> of the incision, <a href="/wiki/Thrombophlebitis" title="Thrombophlebitis">thrombophlebitis</a>, bleeding and <a href="/wiki/Adhesion_(medicine)" title="Adhesion (medicine)">adhesions</a>. Evidence indicates that a delay in obtaining surgery after admission results in no measurable difference in outcomes to the person with appendicitis.<sup id="cite_ref-96" class="reference"><a href="#cite_note-96"><span class="cite-bracket">[</span>96<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-97" class="reference"><a href="#cite_note-97"><span class="cite-bracket">[</span>97<span class="cite-bracket">]</span></a></sup> </p> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Scarlapappendix.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/92/Scarlapappendix.jpg/220px-Scarlapappendix.jpg" decoding="async" width="220" height="159" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/92/Scarlapappendix.jpg/330px-Scarlapappendix.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/92/Scarlapappendix.jpg/440px-Scarlapappendix.jpg 2x" data-file-width="2548" data-file-height="1839" /></a><figcaption>Laparoscopic-assisted transumbilical appendectomy scar on a pediatric patient. Anesthetic result one month after surgery.</figcaption></figure> <p>The surgeon will explain how long the recovery process should take. Abdomen hair is usually removed to avoid complications that may appear regarding the incision. </p><p>In most cases, patients going in for surgery experience nausea or vomiting that require medication before surgery. Antibiotics, along with pain medication, may be administered before appendectomies. </p> <div class="mw-heading mw-heading4"><h4 id="After_surgery">After surgery</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=21" title="Edit section: After surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Stitches_post_appendicitis_surgery.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c5/Stitches_post_appendicitis_surgery.jpg/220px-Stitches_post_appendicitis_surgery.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c5/Stitches_post_appendicitis_surgery.jpg/330px-Stitches_post_appendicitis_surgery.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c5/Stitches_post_appendicitis_surgery.jpg/440px-Stitches_post_appendicitis_surgery.jpg 2x" data-file-width="2816" data-file-height="2112" /></a><figcaption>The <a href="/wiki/Surgical_suture" title="Surgical suture">stitches</a> the day after having the appendix removed by laparoscopic surgery</figcaption></figure> <p>Hospital lengths of stay typically range from a few hours to a few days but can be a few weeks if complications occur. The recovery process may vary depending on the severity of the condition: if the appendix had ruptured or not before surgery. Appendix surgery recovery is generally much faster if the appendix does not rupture.<sup id="cite_ref-98" class="reference"><a href="#cite_note-98"><span class="cite-bracket">[</span>98<span class="cite-bracket">]</span></a></sup> It is important that people undergoing surgery respect their doctor's advice and limit their physical activity so the tissues can heal. Recovery after an appendectomy may not require diet changes or a lifestyle change. </p><p>The length of hospital stays for appendicitis varies on the severity of the condition. A study from the United States found that in 2010, the average appendicitis hospital stay was 1.8 days. For stays where the person's appendix had ruptured, the average length of stay was 5.2 days.<sup id="cite_ref-Barrett2013_14-1" class="reference"><a href="#cite_note-Barrett2013-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>After surgery, the patient will be transferred to a <a href="/wiki/Postanesthesia_care_unit" class="mw-redirect" title="Postanesthesia care unit">postanesthesia care unit</a>, so their vital signs can be closely monitored to detect anesthesia- or surgery-related complications. Pain medication may be administered if necessary. After patients are completely awake, they are moved to a hospital room to recover. Most individuals will be offered clear liquids the day after the surgery, then progress to a regular diet when the intestines start to function correctly. Patients are recommended to sit on the edge of the bed and walk short distances several times a day. Moving is mandatory, and pain medication may be given if necessary. Full recovery from appendectomies takes about four to six weeks but can be prolonged to up to eight weeks if the appendix has ruptured. </p> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=22" title="Edit section: Prognosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Most people with appendicitis recover quickly after surgical treatment, but complications can occur if treatment is delayed or if <a href="/wiki/Peritonitis" title="Peritonitis">peritonitis</a> occurs. Recovery time depends on age, condition, complications, and other circumstances, including the amount of alcohol consumption, but usually is between 10 and 28 days. For young children (around ten years old), the recovery takes three weeks. </p><p>The possibility of peritonitis is the reason why acute appendicitis warrants rapid evaluation and treatment. People with suspected appendicitis may have to undergo a <a href="/wiki/Medical_evacuation" title="Medical evacuation">medical evacuation</a>. Appendectomies have occasionally been performed in emergency conditions (i.e., not in a proper hospital) when a timely medical evacuation was impossible. </p><p>Typical acute appendicitis responds quickly to appendectomy and occasionally will resolve spontaneously. If appendicitis resolves spontaneously, it remains controversial whether an elective interval appendectomy should be performed to prevent a recurrent episode of appendicitis. Atypical appendicitis (associated with suppurative appendicitis) is more challenging to diagnose and is more apt to be complicated even when operated early. In either condition, prompt diagnosis and appendectomy yield the best results with full recovery in two to four weeks usually. Mortality and severe complications are unusual but do occur, especially if peritonitis persists and is untreated. </p><p>Another entity known as the appendicular lump is talked about. It happens when the appendix is not removed early during infection, and the omentum and intestine adhere to it, forming a palpable lump. During this period, surgery is risky unless there is pus formation evident by fever and toxicity or by ultrasound. Medical management treats the condition. </p><p>An unusual complication of an appendectomy is "stump appendicitis": inflammation occurs in the remnant appendiceal stump left after a prior incomplete appendectomy.<sup id="cite_ref-pmid16536249_99-0" class="reference"><a href="#cite_note-pmid16536249-99"><span class="cite-bracket">[</span>99<span class="cite-bracket">]</span></a></sup> Stump appendicitis can occur months to years after initial appendectomy and can be identified with imaging modalities such as ultrasound.<sup id="cite_ref-100" class="reference"><a href="#cite_note-100"><span class="cite-bracket">[</span>100<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=23" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The history of appendicitis traces back to ancient medical texts, though its clear clinical understanding emerged in the 19th century. Berengario da Carpi provided the first recorded description of the appendix in the 16th century, followed by <a href="/wiki/Andreas_Vesalius" title="Andreas Vesalius">Andreas Vesalius</a> and <a href="/wiki/Gabriele_Falloppio" title="Gabriele Falloppio">Gabriele Falloppio</a>. Clinical understanding progressed in the 18th and 19th centuries, marked by Lorenz Heister's autopsy findings, Claudius Aymand's surgical intervention, and J. Mestivier's operation for appendicitis. Prior to the use of the term <i>appendicitis</i>, it was described with terms including <i>perityphlitis</i>, <i>typhlitis</i>, <i>paratyphlitis</i>, and <i>extra-peritoneal abscess of the right iliac fossa</i>.<sup id="cite_ref-101" class="reference"><a href="#cite_note-101"><span class="cite-bracket">[</span>101<span class="cite-bracket">]</span></a></sup> The term "appendicitis" was coined by the American physician <a href="/wiki/Reginald_Heber_Fitz" title="Reginald Heber Fitz">Reginald Heber Fitz</a> in 1886, leading to standardized diagnosis and treatment, including Charles McBurney's identification of McBurney's point. Modern appendectomy techniques evolved in the early 20th century, coinciding with advancements in pathology, notably demonstrated by Ludwig Aschoff in 1908.<sup id="cite_ref-RONDELLI2017_102-0" class="reference"><a href="#cite_note-RONDELLI2017-102"><span class="cite-bracket">[</span>102<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-103" class="reference"><a href="#cite_note-103"><span class="cite-bracket">[</span>103<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=24" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Appendicitis_world_map-Deaths_per_million_persons-WHO2012.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Appendicitis_world_map-Deaths_per_million_persons-WHO2012.svg/290px-Appendicitis_world_map-Deaths_per_million_persons-WHO2012.svg.png" decoding="async" width="290" height="128" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Appendicitis_world_map-Deaths_per_million_persons-WHO2012.svg/435px-Appendicitis_world_map-Deaths_per_million_persons-WHO2012.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Appendicitis_world_map-Deaths_per_million_persons-WHO2012.svg/580px-Appendicitis_world_map-Deaths_per_million_persons-WHO2012.svg.png 2x" data-file-width="940" data-file-height="415" /></a><figcaption>Appendicitis deaths per million persons in 2012 <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col div-col-small" style="column-width: 10em;"> <style data-mw-deduplicate="TemplateStyles:r981673959">.mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{}</style><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffff20; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 0</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffe820; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 1</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffc020; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 2</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffa020; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 3</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff9a20; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 4</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#f08015; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 5–7</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#e06815; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 8–11</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#d85010; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 12–33</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#d02010; color:white;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 34–77</div> </div></figcaption></figure> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Appendicitis_world_map_-_DALY_-_WHO2004.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/20/Appendicitis_world_map_-_DALY_-_WHO2004.svg/290px-Appendicitis_world_map_-_DALY_-_WHO2004.svg.png" decoding="async" width="290" height="128" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/20/Appendicitis_world_map_-_DALY_-_WHO2004.svg/435px-Appendicitis_world_map_-_DALY_-_WHO2004.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/20/Appendicitis_world_map_-_DALY_-_WHO2004.svg/580px-Appendicitis_world_map_-_DALY_-_WHO2004.svg.png 2x" data-file-width="940" data-file-height="415" /></a><figcaption><a href="/wiki/Disability-adjusted_life_year" title="Disability-adjusted life year">Disability-adjusted life year</a> for appendicitis per 100,000 inhabitants in 2004.<sup id="cite_ref-104" class="reference"><a href="#cite_note-104"><span class="cite-bracket">[</span>104<span class="cite-bracket">]</span></a></sup> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1184024115"><div class="div-col div-col-small" style="column-width: 10em;"> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#b3b3b3; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> no data</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffff65; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> less than 2.5</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#fff200; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 2.5–5</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffdc00; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 5–7.5</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffc600; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 7.5–10</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffb000; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 10–12.5</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff9a00; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 12.5–15</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff8400; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 15–17.5</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff6e00; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 17.5–20</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff5800; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 20–22.5</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff4200; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 22.5–25</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff2c00; color:black;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> 25–27.5</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#cb0000; color:white;-webkit-print-color-adjust: exact; print-color-adjust: exact;"> </span> more than 27.5</div> </div></figcaption></figure> <p>Appendicitis is most common between the ages of 5 and 40.<sup id="cite_ref-105" class="reference"><a href="#cite_note-105"><span class="cite-bracket">[</span>105<span class="cite-bracket">]</span></a></sup> In 2013, it resulted in 72,000 deaths globally, down from 88,000 in 1990.<sup id="cite_ref-GBD2014_106-0" class="reference"><a href="#cite_note-GBD2014-106"><span class="cite-bracket">[</span>106<span class="cite-bracket">]</span></a></sup> </p><p>In the United States, there were nearly 293,000 hospitalizations involving appendicitis in 2010.<sup id="cite_ref-Barrett2013_14-2" class="reference"><a href="#cite_note-Barrett2013-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Appendicitis is one of the most frequent diagnoses for emergency department visits resulting in hospitalization among children ages 5–17 years in the United States.<sup id="cite_ref-107" class="reference"><a href="#cite_note-107"><span class="cite-bracket">[</span>107<span class="cite-bracket">]</span></a></sup> </p><p>Adults presenting to the emergency department with a known family history of appendicitis are more likely to have this disease than those without.<sup id="cite_ref-108" class="reference"><a href="#cite_note-108"><span class="cite-bracket">[</span>108<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=25" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Category:Deaths_from_appendicitis" title="Category:Deaths from appendicitis">Deaths from appendicitis</a></li> <li><a href="/wiki/Evan_O%27Neill_Kane" title="Evan O'Neill Kane">Evan O'Neill Kane</a></li> <li><a href="/wiki/Leonid_Rogozov" title="Leonid Rogozov">Leonid Rogozov</a></li></ul> <div style="clear:both;" class=""></div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=26" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output 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.cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.merriam-webster.com/medical/epityphlitis">"appendicitis"</a>. <i>Medical Dictionary</i>. 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Retrieved <span class="nowrap">15 June</span> 2016</span>. <q>Physical signs classically associated with acute appendicitis include Rovsing sign, psoas sign, and obturator sign.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Harwood-Nuss%27+Clinical+Practice+of+Emergency+Medicine&rft.pages=5810&rft.pub=Wolters+Kluwer+Health&rft.date=2014&rft.isbn=978-1-4698-8948-1&rft.aulast=Wolfson&rft.aufirst=Allan+B.&rft.au=Cloutier%2C+Robert+L.&rft.au=Hendey%2C+Gregory+W.&rft.au=Ling%2C+Louis+J.&rft.au=Schaider%2C+Jeffrey+J.&rft.au=Rosen%2C+Carlo+L.&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DcgMYBQAAQBAJ%26pg%3DPT5810&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAppendicitis" class="Z3988"></span></span> </li> <li id="cite_note-45"><span class="mw-cite-backlink"><b><a href="#cite_ref-45">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRovsing1907" class="citation journal cs1 cs1-prop-foreign-lang-source">Rovsing N (1907). 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=report&rft.btitle=Overview+of+Children+in+the+Emergency+Department%2C+2010&rft.pub=Agency+for+Healthcare+Research+and+Quality&rft.date=2013-06&rft.aulast=Wier&rft.aufirst=Lauren+M.&rft.au=Yu%2C+Hao&rft.au=Owens%2C+Pamela+L.&rft.au=Washington%2C+Raynard&rft_id=https%3A%2F%2Fhcup-us.ahrq.gov%2Freports%2Fstatbriefs%2Fsb157.jsp&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAppendicitis" class="Z3988"></span></span> </li> <li id="cite_note-108"><span class="mw-cite-backlink"><b><a href="#cite_ref-108">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDrescherMarcotteGrantStaff2012" class="citation journal cs1">Drescher M, Marcotte S, Grant R, Staff I (2012-12-01). <a rel="nofollow" class="external text" href="http://www.escholarship.org/uc/item/9zf1h82p">"Family History is a Predictor for Appendicitis in Adults in the Emergency Department"</a>. <i>Western Journal of Emergency Medicine</i>. <b>13</b> (6): <span class="nowrap">468–</span>471. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5811%2Fwestjem.2011.6.6679">10.5811/westjem.2011.6.6679</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555584">3555584</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23359540">23359540</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Western+Journal+of+Emergency+Medicine&rft.atitle=Family+History+is+a+Predictor+for+Appendicitis+in+Adults+in+the+Emergency+Department&rft.volume=13&rft.issue=6&rft.pages=%3Cspan+class%3D%22nowrap%22%3E468-%3C%2Fspan%3E471&rft.date=2012-12-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3555584%23id-name%3DPMC&rft_id=info%3Apmid%2F23359540&rft_id=info%3Adoi%2F10.5811%2Fwestjem.2011.6.6679&rft.aulast=Drescher&rft.aufirst=Michael&rft.au=Marcotte%2C+Shannon&rft.au=Grant%2C+Robert&rft.au=Staff%2C+Ilene&rft_id=http%3A%2F%2Fwww.escholarship.org%2Fuc%2Fitem%2F9zf1h82p&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAppendicitis" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Appendicitis&action=edit&section=27" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}</style><style data-mw-deduplicate="TemplateStyles:r1237033735">@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}</style><div class="side-box side-box-right plainlinks sistersitebox"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Commons-logo.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png" decoding="async" width="30" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/45px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/59px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></a></span></div> <div class="side-box-text plainlist">Wikimedia Commons has media related to <span style="font-weight: bold; font-style: italic;"><a href="https://commons.wikimedia.org/wiki/Category:Appendicitis" class="extiw" title="commons:Category:Appendicitis">Appendicitis</a></span>.</div></div> </div> <ul><li><a rel="nofollow" class="external text" href="http://www.claripacs.com/case/CL0012">CT of the abdomen showing acute appendicitis</a></li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20070223052616/http://www.surgeons.org.uk/general-surgery-tutorials/appendicitis.html">Appendicitis, history, diagnosis and treatment</a> by Surgeons Net Education</li> <li><a rel="nofollow" class="external text" href="http://www.merck.com/mmpe/sec02/ch011/ch011e.html">Appendicitis: Acute Abdomen and Surgical Gastroenterology</a> from the Merck Manual Professional (content last modified September 2007)</li> <li><a rel="nofollow" class="external text" href="https://www.healthnsurgery.com/appendicitis-symptoms-causes-and-treatment/">Appendicitis – Symptoms Causes and Treatment</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20210227115251/https://www.healthnsurgery.com/appendicitis-symptoms-causes-and-treatment/">Archived</a> 2021-02-27 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a> at Health N Surgery</li></ul> <div class="navbox-styles"><style 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· ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox32" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q121041" class="extiw" title="d:Q121041">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/K35">K35</a> - <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/K37">K37</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=540">540</a>-<a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=543">543</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D001064">D001064</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb885.htm">885</a></li><li><b><a href="/wiki/SNOMED_CT" title="SNOMED CT">SNOMED CT</a></b>: <a rel="nofollow" class="external text" href="http://snomed.info/id/74400008">74400008</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000256.htm">000256</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/3430-overview">med/3430</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/emerg/topic41.htm#">emerg/41</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/ped/topic127.htm#">ped/127</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/ped/topic2925.htm#">ped/2925</a></li><li><b><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a></b>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/appendicitis-pro">Appendicitis</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_the_human_digestive_system290" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Digestive_system_diseases" title="Template:Digestive system diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Digestive_system_diseases" title="Template talk:Digestive system diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Digestive_system_diseases" title="Special:EditPage/Template:Digestive system diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diseases_of_the_human_digestive_system290" style="font-size:114%;margin:0 4em">Diseases of the <a href="/wiki/Human_digestive_system" title="Human digestive system">human digestive system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_tract#Upper_gastrointestinal_tract" title="Gastrointestinal tract">Upper GI tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Esophageal_disease" title="Esophageal disease">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Esophagitis" title="Esophagitis">Esophagitis</a> <ul><li><a href="/wiki/Esophageal_candidiasis" title="Esophageal candidiasis">Candidal</a></li> <li><a href="/wiki/Eosinophilic_esophagitis" title="Eosinophilic esophagitis">Eosinophilic</a></li> <li><a href="/wiki/Herpetiform_esophagitis" class="mw-redirect" title="Herpetiform esophagitis">Herpetiform</a></li></ul></li> <li><i>Rupture</i> <ul><li><a href="/wiki/Boerhaave_syndrome" class="mw-redirect" title="Boerhaave syndrome">Boerhaave syndrome</a></li> <li><a href="/wiki/Mallory%E2%80%93Weiss_syndrome" title="Mallory–Weiss syndrome">Mallory–Weiss syndrome</a></li></ul></li> <li><a href="/wiki/Zenker%27s_diverticulum" title="Zenker's diverticulum">Zenker's diverticulum</a></li> <li><a href="/wiki/Barrett%27s_esophagus" title="Barrett's esophagus">Barrett's esophagus</a></li> <li><a href="/wiki/Esophageal_motility_disorder" title="Esophageal motility disorder">Esophageal motility disorder</a> <ul><li><a href="/wiki/Nutcracker_esophagus" title="Nutcracker esophagus">Nutcracker esophagus</a></li> <li><a href="/wiki/Achalasia" class="mw-redirect" title="Achalasia">Achalasia</a></li> <li><a href="/wiki/Esophagogastric_junction_outflow_obstruction" title="Esophagogastric junction outflow obstruction">Esophagogastric junction outflow obstruction</a></li> <li><a href="/wiki/Diffuse_esophageal_spasm" title="Diffuse esophageal spasm">Diffuse esophageal spasm</a></li> <li><a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">Gastroesophageal reflux disease</a> (GERD)</li></ul></li> <li><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</li> <li><a href="/wiki/Esophageal_stricture" title="Esophageal stricture">Esophageal stricture</a></li> <li><a href="/wiki/Esophageal_inlet_patch" title="Esophageal inlet patch">Inlet patch</a></li> <li><a href="/wiki/Megaesophagus" title="Megaesophagus">Megaesophagus</a></li> <li><a href="/wiki/Esophageal_intramural_pseudodiverticulosis" title="Esophageal intramural pseudodiverticulosis">Esophageal intramural pseudodiverticulosis</a></li> <li><a href="/wiki/Acute_esophageal_necrosis" title="Acute esophageal necrosis">Acute esophageal necrosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Stomach_disease" title="Stomach disease">Stomach</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gastritis" title="Gastritis">Gastritis</a> <ul><li><a href="/wiki/Atrophic_gastritis" title="Atrophic gastritis">Atrophic</a></li> <li><a href="/wiki/M%C3%A9n%C3%A9trier%27s_disease" title="Ménétrier's disease">Ménétrier's disease</a></li> <li><a href="/wiki/Gastroenteritis" title="Gastroenteritis">Gastroenteritis</a></li></ul></li> <li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (gastric) ulcer</a> <ul><li><a href="/wiki/Cushing_ulcer" title="Cushing ulcer">Cushing ulcer</a></li> <li><a href="/wiki/Dieulafoy%27s_lesion" title="Dieulafoy's lesion">Dieulafoy's lesion</a></li></ul></li> <li><a href="/wiki/Dyspepsia" class="mw-redirect" title="Dyspepsia">Dyspepsia</a> <ul><li><a href="/wiki/Functional_dyspepsia" title="Functional dyspepsia">Functional dyspepsia</a></li></ul></li> <li><a href="/wiki/Pyloric_stenosis" title="Pyloric stenosis">Pyloric stenosis</a></li> <li><a href="/wiki/Achlorhydria" title="Achlorhydria">Achlorhydria</a></li> <li><a href="/wiki/Gastroparesis" title="Gastroparesis">Gastroparesis</a></li> <li><a href="/wiki/Gastroptosis" title="Gastroptosis">Gastroptosis</a></li> <li><a href="/wiki/Portal_hypertensive_gastropathy" title="Portal hypertensive gastropathy">Portal hypertensive gastropathy</a></li> <li><a href="/wiki/Gastric_antral_vascular_ectasia" title="Gastric antral vascular ectasia">Gastric antral vascular ectasia</a></li> <li><a href="/wiki/Gastric_dumping_syndrome" class="mw-redirect" title="Gastric dumping syndrome">Gastric dumping syndrome</a></li> <li><a href="/wiki/Gastric_volvulus" title="Gastric volvulus">Gastric volvulus</a></li> <li><a href="/wiki/Buried_bumper_syndrome" title="Buried bumper syndrome">Buried bumper syndrome</a></li> <li><a href="/wiki/Gastrinoma" title="Gastrinoma">Gastrinoma</a> <ul><li><a href="/wiki/Zollinger%E2%80%93Ellison_syndrome" title="Zollinger–Ellison syndrome">Zollinger–Ellison syndrome</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_tract#Lower_gastrointestinal_tract" title="Gastrointestinal tract">Lower GI tract</a> <br /> <a href="/wiki/Enteropathy" title="Enteropathy">Enteropathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Small_intestine" title="Small intestine">Small intestine</a> <br /> (<a href="/wiki/Duodenum" title="Duodenum">Duodenum</a>/<a href="/wiki/Jejunum" title="Jejunum">Jejunum</a>/<a href="/wiki/Ileum" title="Ileum">Ileum</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Enteritis" title="Enteritis">Enteritis</a> <ul><li><a href="/wiki/Duodenitis" title="Duodenitis">Duodenitis</a></li> <li><a href="/wiki/Jejunitis" title="Jejunitis">Jejunitis</a></li> <li><a href="/wiki/Ileitis" title="Ileitis">Ileitis</a></li></ul></li> <li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (duodenal) ulcer</a> <ul><li><a href="/wiki/Curling%27s_ulcer" title="Curling's ulcer">Curling's ulcer</a></li></ul></li> <li><a href="/wiki/Malabsorption" title="Malabsorption">Malabsorption</a>: <a href="/wiki/Coeliac_disease" title="Coeliac disease">Coeliac</a></li> <li><a href="/wiki/Tropical_sprue" title="Tropical sprue">Tropical sprue</a></li> <li><a href="/wiki/Blind_loop_syndrome" title="Blind loop syndrome">Blind loop syndrome</a></li> <li><a href="/wiki/Small_intestinal_bacterial_overgrowth" title="Small intestinal bacterial overgrowth">Small intestinal bacterial overgrowth</a></li> <li><a href="/wiki/Whipple%27s_disease" title="Whipple's disease">Whipple's</a></li> <li><a href="/wiki/Short_bowel_syndrome" title="Short bowel syndrome">Short bowel syndrome</a></li> <li><a href="/wiki/Steatorrhea" title="Steatorrhea">Steatorrhea</a></li> <li><a href="/wiki/Milroy_disease" class="mw-redirect" title="Milroy disease">Milroy disease</a></li> <li><a href="/wiki/Bile_acid_malabsorption" title="Bile acid malabsorption">Bile acid malabsorption</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Large_intestine" title="Large intestine">Large intestine</a> <br /> (<a href="/wiki/Vermiform_appendix" class="mw-redirect" title="Vermiform appendix">Appendix</a>/<a href="/wiki/Colon_(anatomy)" class="mw-redirect" title="Colon (anatomy)">Colon</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Appendicitis</a></li> <li><a href="/wiki/Colitis" title="Colitis">Colitis</a> <ul><li><a href="/wiki/Pseudomembranous_colitis" class="mw-redirect" title="Pseudomembranous colitis">Pseudomembranous</a></li> <li><a href="/wiki/Ulcerative_colitis" title="Ulcerative colitis">Ulcerative</a></li> <li><a href="/wiki/Ischemic_colitis" title="Ischemic colitis">Ischemic</a></li> <li><a href="/wiki/Microscopic_colitis" title="Microscopic colitis">Microscopic</a></li> <li><a href="/wiki/Collagenous_colitis" title="Collagenous colitis">Collagenous</a></li> <li><a href="/wiki/Lymphocytic_colitis" title="Lymphocytic colitis">Lymphocytic</a></li></ul></li> <li><a href="/wiki/Dysentery" title="Dysentery">Dysentery</a></li> <li><a href="/wiki/Functional_colonic_disease" class="mw-redirect" title="Functional colonic disease">Functional colonic disease</a> <ul><li><a href="/wiki/Irritable_bowel_syndrome" title="Irritable bowel syndrome">IBS</a></li> <li><a href="/wiki/Intestinal_pseudoobstruction" class="mw-redirect" title="Intestinal pseudoobstruction">Intestinal pseudoobstruction</a> / <a href="/wiki/Ogilvie_syndrome" title="Ogilvie syndrome">Ogilvie syndrome</a></li></ul></li> <li><a href="/wiki/Megacolon" title="Megacolon">Megacolon</a> / <a href="/wiki/Toxic_megacolon" title="Toxic megacolon">Toxic megacolon</a></li> <li><a href="/wiki/Diverticulitis" title="Diverticulitis">Diverticulitis</a>/<a href="/wiki/Diverticulosis" title="Diverticulosis">Diverticulosis</a>/<a href="/wiki/Segmental_colitis_associated_with_diverticulosis" title="Segmental colitis associated with diverticulosis">SCAD</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Large and/or small</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Enterocolitis" title="Enterocolitis">Enterocolitis</a> <ul><li><a href="/wiki/Necrotizing_enterocolitis" title="Necrotizing enterocolitis">Necrotizing</a></li></ul></li> <li><a href="/wiki/Gastroenterocolitis" title="Gastroenterocolitis">Gastroenterocolitis</a></li> <li><a href="/wiki/Inflammatory_bowel_disease" title="Inflammatory bowel disease">IBD</a> <ul><li><a href="/wiki/Crohn%27s_disease" title="Crohn's disease">Crohn's disease</a></li></ul></li> <li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i>: <a href="/wiki/Abdominal_angina" title="Abdominal angina">Abdominal angina</a></li> <li><a href="/wiki/Mesenteric_ischemia" class="mw-redirect" title="Mesenteric ischemia">Mesenteric ischemia</a></li> <li><a href="/wiki/Angiodysplasia" title="Angiodysplasia">Angiodysplasia</a></li> <li><a href="/wiki/Bowel_obstruction" title="Bowel obstruction">Bowel obstruction</a>: <a href="/wiki/Ileus" title="Ileus">Ileus</a></li> <li><a href="/wiki/Intussusception_(medical_disorder)" title="Intussusception (medical disorder)">Intussusception</a></li> <li><a href="/wiki/Volvulus" title="Volvulus">Volvulus</a></li> <li><a href="/wiki/Fecal_impaction" title="Fecal impaction">Fecal impaction</a></li> <li><a href="/wiki/Constipation" title="Constipation">Constipation</a> <ul><li><a href="/wiki/Functional_constipation" title="Functional constipation">Functional</a></li></ul></li> <li><a href="/wiki/Diarrhea" title="Diarrhea">Diarrhea</a> <ul><li><a href="/wiki/Infectious_diarrhea" class="mw-redirect" title="Infectious diarrhea">Infectious</a></li></ul></li> <li><a href="/wiki/Adhesion_(medicine)" title="Adhesion (medicine)">Intestinal adhesions</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rectum" title="Rectum">Rectum</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Proctitis" title="Proctitis">Proctitis</a> <ul><li><a href="/wiki/Radiation_proctitis" title="Radiation proctitis">Radiation proctitis</a></li></ul></li> <li><a href="/wiki/Proctalgia_fugax" title="Proctalgia fugax">Proctalgia fugax</a></li> <li><a href="/wiki/Rectal_prolapse" title="Rectal prolapse">Rectal prolapse</a></li> <li><a href="/wiki/Anismus" title="Anismus">Anismus</a></li> <li><a href="/wiki/Solitary_rectal_ulcer_syndrome" title="Solitary rectal ulcer syndrome">Solitary rectal ulcer syndrome</a></li> <li><a href="/wiki/Rectal_stricture" title="Rectal stricture">Rectal stricture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anal_canal" title="Anal canal">Anal canal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anal_fissure" title="Anal fissure">Anal fissure</a>/<a href="/wiki/Anal_fistula" title="Anal fistula">Anal fistula</a></li> <li><a href="/wiki/Anal_abscess" class="mw-redirect" title="Anal abscess">Anal abscess</a></li> <li><a href="/wiki/Hemorrhoid" title="Hemorrhoid">Hemorrhoid</a></li> <li><a href="/wiki/Anal_dysplasia" title="Anal dysplasia">Anal dysplasia</a></li> <li><a href="/wiki/Pruritus_ani" title="Pruritus ani">Pruritus ani</a></li> <li><a href="/wiki/Anal_stricture" title="Anal stricture">Anal stricture</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_bleeding" title="Gastrointestinal bleeding">GI bleeding</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blood_in_stool" title="Blood in stool">Blood in stool</a></li> <li><a href="/wiki/Upper_gastrointestinal_bleeding" title="Upper gastrointestinal bleeding">Upper</a> <ul><li><a href="/wiki/Hematemesis" title="Hematemesis">Hematemesis</a></li> <li><a href="/wiki/Melena" title="Melena">Melena</a></li></ul></li> <li><a href="/wiki/Lower_gastrointestinal_bleeding" title="Lower gastrointestinal bleeding">Lower</a> <ul><li><a href="/wiki/Hematochezia" title="Hematochezia">Hematochezia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Accessory_digestive_gland" class="mw-redirect" title="Accessory digestive gland">Accessory</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Liver_disease" title="Liver disease">Liver</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hepatitis" title="Hepatitis">Hepatitis</a> <ul><li><a href="/wiki/Viral_hepatitis" title="Viral hepatitis">Viral hepatitis</a></li> <li><a href="/wiki/Autoimmune_hepatitis" title="Autoimmune hepatitis">Autoimmune hepatitis</a></li> <li><a href="/wiki/Alcoholic_hepatitis" title="Alcoholic hepatitis">Alcoholic hepatitis</a></li></ul></li> <li><a href="/wiki/Cirrhosis" title="Cirrhosis">Cirrhosis</a> <ul><li><a href="/wiki/Primary_biliary_cirrhosis" class="mw-redirect" title="Primary biliary cirrhosis">PBC</a></li></ul></li> <li><a href="/wiki/Fatty_liver" class="mw-redirect" title="Fatty liver">Fatty liver</a> <ul><li><a href="/wiki/Metabolic_dysfunction%E2%80%93associated_steatotic_liver_disease" title="Metabolic dysfunction–associated steatotic liver disease">MASLD</a></li></ul></li> <li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i> <ul><li><a href="/wiki/Budd%E2%80%93Chiari_syndrome" title="Budd–Chiari syndrome">Budd–Chiari syndrome</a></li> <li><a href="/wiki/Hepatic_veno-occlusive_disease" title="Hepatic veno-occlusive disease">Hepatic veno-occlusive disease</a></li> <li><a href="/wiki/Portal_hypertension" title="Portal hypertension">Portal hypertension</a></li> <li><a href="/wiki/Nutmeg_liver" class="mw-redirect" title="Nutmeg liver">Nutmeg liver</a></li></ul></li> <li><a href="/wiki/Alcoholic_liver_disease" title="Alcoholic liver disease">Alcoholic liver disease</a></li> <li><a href="/wiki/Liver_failure" title="Liver failure">Liver failure</a> <ul><li><a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">Hepatic encephalopathy</a></li> <li><a href="/wiki/Acute_liver_failure" title="Acute liver failure">Acute liver failure</a></li></ul></li> <li><a href="/wiki/Liver_abscess" title="Liver abscess">Liver abscess</a> <ul><li><a href="/wiki/Pyogenic_liver_abscess" title="Pyogenic liver abscess">Pyogenic</a></li> <li><a href="/wiki/Amoebic_liver_abscess" title="Amoebic liver abscess">Amoebic</a></li></ul></li> <li><a href="/wiki/Hepatorenal_syndrome" title="Hepatorenal syndrome">Hepatorenal syndrome</a></li> <li><a href="/wiki/Peliosis_hepatis" title="Peliosis hepatis">Peliosis hepatis</a></li> <li><a href="/wiki/Metabolic_disorder" title="Metabolic disorder">Metabolic disorders</a> <ul><li><a href="/wiki/Wilson%27s_disease" title="Wilson's disease">Wilson's disease</a></li> <li><a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">Hemochromatosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gallbladder_disease" title="Gallbladder disease">Gallbladder</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholecystitis" title="Cholecystitis">Cholecystitis</a></li> <li><a href="/wiki/Gallstone" title="Gallstone">Gallstone / Cholelithiasis</a></li> <li><a href="/wiki/Cholesterolosis_of_gallbladder" title="Cholesterolosis of gallbladder">Cholesterolosis</a></li> <li><a href="/wiki/Adenomyomatosis" title="Adenomyomatosis">Adenomyomatosis</a></li> <li><a href="/wiki/Postcholecystectomy_syndrome" title="Postcholecystectomy syndrome">Postcholecystectomy syndrome</a></li> <li><a href="/wiki/Porcelain_gallbladder" title="Porcelain gallbladder">Porcelain gallbladder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bile_duct" title="Bile duct">Bile duct</a>/ <br /> Other <a href="/wiki/Biliary_tree" class="mw-redirect" title="Biliary tree">biliary tree</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholangitis" class="mw-redirect" title="Cholangitis">Cholangitis</a> <ul><li><a href="/wiki/Primary_sclerosing_cholangitis" title="Primary sclerosing cholangitis">Primary sclerosing cholangitis</a></li> <li><a href="/wiki/Secondary_sclerosing_cholangitis" title="Secondary sclerosing cholangitis">Secondary sclerosing cholangitis</a></li> <li><a href="/wiki/Ascending_cholangitis" title="Ascending cholangitis">Ascending</a></li></ul></li> <li><a href="/wiki/Cholestasis" title="Cholestasis">Cholestasis</a>/<a href="/wiki/Mirizzi%27s_syndrome" title="Mirizzi's syndrome">Mirizzi's syndrome</a></li> <li><a href="/wiki/Biliary_fistula" title="Biliary fistula">Biliary fistula</a></li> <li><a href="/wiki/Haemobilia" title="Haemobilia">Haemobilia</a></li></ul> <ul><li><i><a href="/wiki/Common_bile_duct" title="Common bile duct">Common bile duct</a></i> <ul><li><a href="/wiki/Choledocholithiasis" class="mw-redirect" title="Choledocholithiasis">Choledocholithiasis</a></li> <li><a href="/wiki/Biliary_dyskinesia" title="Biliary dyskinesia">Biliary dyskinesia</a></li></ul></li> <li><a href="/wiki/Sphincter_of_Oddi_dysfunction" title="Sphincter of Oddi dysfunction">Sphincter of Oddi dysfunction</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatic_disease" title="Pancreatic disease">Pancreatic</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pancreatitis" title="Pancreatitis">Pancreatitis</a> <ul><li><a href="/wiki/Acute_pancreatitis" title="Acute pancreatitis">Acute</a></li> <li><a href="/wiki/Chronic_pancreatitis" title="Chronic pancreatitis">Chronic</a></li> <li><a href="/wiki/Hereditary_pancreatitis" title="Hereditary pancreatitis">Hereditary</a></li> <li><a href="/wiki/Pancreatic_abscess" title="Pancreatic abscess">Pancreatic abscess</a></li></ul></li> <li><a href="/wiki/Pancreatic_pseudocyst" title="Pancreatic pseudocyst">Pancreatic pseudocyst</a></li> <li><a href="/wiki/Exocrine_pancreatic_insufficiency" title="Exocrine pancreatic insufficiency">Exocrine pancreatic insufficiency</a></li> <li><a href="/wiki/Pancreatic_fistula" title="Pancreatic fistula">Pancreatic fistula</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Hernia43" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hernia" title="Hernia">Hernia</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Diaphragmatic_hernia" title="Diaphragmatic hernia">Diaphragmatic</a> <ul><li><a href="/wiki/Congenital_diaphragmatic_hernia" title="Congenital diaphragmatic hernia">Congenital</a></li></ul></li> <li><a href="/wiki/Hiatus_hernia" class="mw-redirect" title="Hiatus hernia">Hiatus</a></li></ul> <ul><li><a href="/wiki/Inguinal_hernia" title="Inguinal hernia">Inguinal</a> <ul><li><a href="/wiki/Indirect_inguinal_hernia" class="mw-redirect" title="Indirect inguinal hernia">Indirect</a></li> <li><a href="/wiki/Direct_inguinal_hernia" class="mw-redirect" title="Direct inguinal hernia">Direct</a></li></ul></li> <li><a href="/wiki/Umbilical_hernia" title="Umbilical hernia">Umbilical</a></li> <li><a href="/wiki/Femoral_hernia" title="Femoral hernia">Femoral</a></li> <li><a href="/wiki/Obturator_hernia" title="Obturator hernia">Obturator</a></li> <li><a href="/wiki/Spigelian_hernia" title="Spigelian hernia">Spigelian</a></li></ul> <ul><li><i><a href="/wiki/Lumbar_hernia" class="mw-redirect" title="Lumbar hernia">Lumbar</a></i> <ul><li><a href="/wiki/Petit%27s_hernia" title="Petit's hernia">Petit's</a></li> <li><a href="/wiki/Grynfeltt%E2%80%93Lesshaft_hernia" title="Grynfeltt–Lesshaft hernia">Grynfeltt–Lesshaft</a></li></ul></li></ul> <ul><li><i>Undefined location</i> <ul><li><a href="/wiki/Incisional_hernia" title="Incisional hernia">Incisional</a></li> <li><a href="/wiki/Internal_hernia" title="Internal hernia">Internal hernia</a></li> <li><a href="/wiki/Richter%27s_hernia" title="Richter's hernia">Richter's</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peritoneal_disease" class="mw-redirect" title="Peritoneal disease">Peritoneal</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Peritonitis" title="Peritonitis">Peritonitis</a> <ul><li><a href="/wiki/Spontaneous_bacterial_peritonitis" title="Spontaneous bacterial peritonitis">Spontaneous bacterial peritonitis</a></li></ul></li> <li><a href="/wiki/Hemoperitoneum" title="Hemoperitoneum">Hemoperitoneum</a></li> <li><a href="/wiki/Pneumoperitoneum" title="Pneumoperitoneum">Pneumoperitoneum</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" 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