Appendicitis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]

Overview

Appendicitis is a condition characterized by inflammation of the appendix. It can be classified into several subtypes based on perforation and the type of obstruction.

Classification

Based on cause of Obstruction

Appendicitis may be classified based on the etiology of obstruction into:

• Infectious appendicitis - Obstruction of appendicial lumen is due to infectious inflammation.
• 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.

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:
  • 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 class

Acute appendicitis

• Symptoms have existed less than 48 hours.

Non acute appendicitis 

• Symptoms have existed for days or weeks, or have recurred several times.