Appendicitis classification: Difference between revisions
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==Overview== | ==Overview== | ||
Appendicitis | Appendicitis may be classified based on based on the duration of symptoms, based on etiology of obstruction and based on whether appendix has been perforated or not. | ||
==Classification== | ==Classification== | ||
=== | ===Based on cause of Obstruction=== | ||
Appendicitis may be classified based on the [[etiology]] of obstruction into:<ref>{{Citation | Appendicitis may be classified based on the [[etiology]] of obstruction into:<ref>{{Citation | ||
| last1 = Yelon | | last1 = Yelon | ||
| Line 21: | Line 21: | ||
}}</ref> | }}</ref> | ||
*Infectious appendicitis - Obstruction of appendicial [[lumen]] is due to infectious [[inflammation]]. | *Infectious appendicitis - Obstruction of appendicial [[lumen]] is due to infectious [[inflammation]]<ref name="pmid26640515">{{cite journal |vauthors=Gomes CA, Sartelli M, Di Saverio S, Ansaloni L, Catena F, Coccolini F, Inaba K, Demetriades D, Gomes FC, Gomes CC |title=Acute appendicitis: proposal of a new comprehensive grading system based on clinical, imaging and laparoscopic findings |journal=World J Emerg Surg |volume=10 |issue= |pages=60 |date=2015 |pmid=26640515 |pmc=4669630 |doi=10.1186/s13017-015-0053-2 |url=}}</ref>. | ||
*[[Fibrosis]] appendicitis- Scar tissue from a previous surgery can lead to obstruction. | *[[Fibrosis]] appendicitis- Scar tissue from a previous surgery can lead to obstruction. | ||
*[[Fecaloma|Fecaliths]] appendicitis - Hard fecal masses block the outlet of appendix | *[[Fecaloma|Fecaliths]] appendicitis - Hard fecal masses block the outlet of appendix | ||
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*Lymphoid [[hyperplasic]] appendicitis Obstruction of lumen due cell hyperplasia. | *Lymphoid [[hyperplasic]] appendicitis Obstruction of lumen due cell hyperplasia. | ||
=== | ===Based on Perforation=== | ||
Appendicitis may be classified based on perforations or non-perforations. | Appendicitis may be classified based on perforations or non-perforations<ref name="pmid30255334">{{cite journal |vauthors=de Wijkerslooth EML, van den Boom AL, Wijnhoven BPL |title=Variation in Classification and Postoperative Management of Complex Appendicitis: A European Survey |journal=World J Surg |volume=43 |issue=2 |pages=439–446 |date=February 2019 |pmid=30255334 |pmc=6329835 |doi=10.1007/s00268-018-4806-4 |url=}}</ref>. | ||
'''Perforating appendicitis''' | '''<u>Perforating appendicitis</u>''' | ||
* The appendiceal wall has been compromised due to pressure and inflammation and the intraluminal contents have leaked out into the peritoneal cavity. | * The appendiceal wall has been compromised due to pressure and inflammation and the intraluminal contents have leaked out into the peritoneal cavity. | ||
* Increases in incidence with age and is associated with the following types of bacterial infiltration:<ref name="pmid2784936">{{cite journal |author=Luckmann R |title=Incidence and case fatality rates for acute appendicitis in California. A population-based study of the effects of age |journal=Am. J. Epidemiol. |volume=129 |issue=5 |pages=905–18 |year=1989 |month=May |pmid=2784936 |doi= |url=}}</ref> | * Increases in incidence with age and is associated with the following types of bacterial infiltration:<ref name="pmid2784936">{{cite journal |author=Luckmann R |title=Incidence and case fatality rates for acute appendicitis in California. A population-based study of the effects of age |journal=Am. J. Epidemiol. |volume=129 |issue=5 |pages=905–18 |year=1989 |month=May |pmid=2784936 |doi= |url=}}</ref> | ||
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**[[Bacteroides fragilis]] | **[[Bacteroides fragilis]] | ||
**Pseudomonas species | **Pseudomonas species | ||
'''Non-perforating appendicitis''' | '''<u>Non-perforating appendicitis</u>''' | ||
*Inflammation is contained within the appendix; no intraluminal contents have leaked out. | *Inflammation is contained within the appendix; no intraluminal contents have leaked out. | ||
=== | === Based on duration of symptoms === | ||
Appendicitis may be | Appendicitis may be classified based on duration of symptoms into: | ||
===== Acute appendicitis ===== | ===== <u>Acute appendicitis</u> ===== | ||
* Symptoms have existed less than 48 hours. | * Symptoms have existed less than 48 hours. | ||
'''Non acute appendicitis''' | '''<u>Non acute appendicitis</u>''' | ||
* | * Symptoms have existed for days or weeks, or have recurred several times. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
Latest revision as of 19:32, 4 October 2020
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Appendicitis On the Web |
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American Roentgen Ray Society Images of Appendicitis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]
Overview
Appendicitis may be classified based on based on the duration of symptoms, based on etiology of obstruction and based on whether appendix has been perforated or not.
Classification
Based on cause of Obstruction
Appendicitis may be classified based on the etiology of obstruction into:[1]
- Infectious appendicitis - Obstruction of appendicial lumen is due to infectious inflammation[2].
- Fibrosis appendicitis- Scar tissue from a previous surgery can lead to obstruction.
- Fecaliths appendicitis - Hard fecal masses block the outlet of appendix
- Neoplasic appendicitis - Carcinoid, adenocarcinoma, or mucocele is responsible for increased secretions resulting in blockage.
- Parasitic appendicitis- In endemic areas obstruction of the appendicial lumen is due to parasitic load.
- Calculic appendicitis
- Lymphoid hyperplasic appendicitis Obstruction of lumen due cell hyperplasia.
Based on Perforation
Appendicitis may be classified based on perforations or non-perforations[3].
Perforating appendicitis
- The appendiceal wall has been compromised due to pressure and inflammation and the intraluminal contents have leaked out into the peritoneal cavity.
- Increases in incidence with age and is associated with the following types of bacterial infiltration:[4]
- Escherichia coli
- Peptostreptococcus
- Bacteroides fragilis
- Pseudomonas species
Non-perforating appendicitis
- Inflammation is contained within the appendix; no intraluminal contents have leaked out.
Based on duration of symptoms
Appendicitis may be classified based on duration of symptoms into:
Acute appendicitis
- Symptoms have existed less than 48 hours.
Non acute appendicitis
- Symptoms have existed for days or weeks, or have recurred several times.
References
- ↑ Yelon, Jay A. & Luchette, Fred A. (2014), Geriatric Trauma and Critical Care (1st ed.), New York, New York: Springer
- ↑ Gomes CA, Sartelli M, Di Saverio S, Ansaloni L, Catena F, Coccolini F, Inaba K, Demetriades D, Gomes FC, Gomes CC (2015). "Acute appendicitis: proposal of a new comprehensive grading system based on clinical, imaging and laparoscopic findings". World J Emerg Surg. 10: 60. doi:10.1186/s13017-015-0053-2. PMC 4669630. PMID 26640515.
- ↑ de Wijkerslooth E, van den Boom AL, Wijnhoven B (February 2019). "Variation in Classification and Postoperative Management of Complex Appendicitis: A European Survey". World J Surg. 43 (2): 439–446. doi:10.1007/s00268-018-4806-4. PMC 6329835. PMID 30255334. Vancouver style error: initials (help)
- ↑ Luckmann R (1989). "Incidence and case fatality rates for acute appendicitis in California. A population-based study of the effects of age". Am. J. Epidemiol. 129 (5): 905–18. PMID 2784936. Unknown parameter
|month=ignored (help)