In this episode, we review acute appendicitis, a common yet time-sensitive surgical emergency. We break down the pathophysiology of luminal obstruction—most often from a fecalith—leading to infection, ischemia, and potential perforation within 24–48 hours if untreated. The discussion covers classic symptom progression from periumbilical pain to right lower quadrant tenderness, key physical exam maneuvers, appropriate imaging strategies, and current treatment standards including antibiotics and laparoscopic appendectomy. High-yield clinical pearls emphasize early recognition, risk of recurrence with nonoperative management, and the role of the Alvarado score alongside imaging to guide diagnosis.

References

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2) Krzyzak M, Mulrooney SM. Acute Appendicitis Review: Background, Epidemiology, Diagnosis, and Treatment. Cureus. 2020 Jun 11;12(6):e8562. doi: 10.7759/cureus.8562. PMID: 32670699; PMCID: PMC7358958.

3) Moris D, Paulson EK, Pappas TN. Diagnosis and Management of Acute Appendicitis in Adults JAMA. 2021; 326(22):2299-.

4) Salminen, P., Haijanen, J., Minneci, P.C. et al. Appendicitis. Nat Rev Dis Primers 11, 79 (2025). https://doi.org/10.1038/s41572-025-00659-6