Classic clinical presentation of acute appendicitis is patients first note vague, poorly localized epigastric or periumbilical discomfort, which typically is not severe and often is attributed to“gastric upset.” Patients commonly report feeling that a bowel movement should make the pain better, a sensation known as the downward urge.
Diarrhea sometimes is seen early. Within 4 to 12 hours of theonset of pain, most patients also have nausea, anorexia,vomiting, or some combination of these three symptoms. Localization of the pain to the right lower quadrant which typically occurs 12 -24 hrs later is a valuable finding and occurs in more than 80% of patients with appendicitis.
The major complication of untreated appendicitis is perforation. Overall, the perforation rate is between 10% and 30%. Perforation is most common at the extremes of age. Perforation rates as high as 90% in children younger than two years and 50-70% in patients older than 70 years.
Treatment of acute appendicitis is and remains appendectomy. Early Diagnosis and timely intervention plays a vital role in avoiding complications.