Acute Appendicitis: Diagnosis and Treatment, with Special Attention to a Laparoscopic Approach

Acute appendicitis is one of the most common causes of acute abdomen. It may occur from the time of infancy to old age, but the peak age of incidence is in the second and third decades of life. The diagnosis is based on a careful history and physical examination. In patients who have atypical clinical and laboratory findings, US, CT, MRI, a scoring system and laparoscopy can be used. Laparoscopic appendectomy is a safe and effective method for the treatment of appendicitis. It has proven advantages in relation to the open method: less post-operative pain, and a short stay in hospital, quicker recovery and return to normal activities. The causes of unsuccessful procedures vary, and most of the reasons for conversion occur due to the operator's lack of experience. In general, laparoscopic appendectomy has advantages, but it must be borne in mind that surgical experience in laparoscopic techniques is a pre-condition for surgeons to expect clinical benefits from laparoscopic appendectomy. In clinical conditions, where surgical experience is present, and the necessary equipment, the use of laparoscopy and laparoscopic appendectomy may be recommended in all patients with suspected appendicitis, if laparoscopy itself is not contra-indicated or is not feasible.