PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

Review Article

Volume 9 Issue 5

Acute Appendicitis in Adults: New Diagnostic and Therapeutic Strategies

Jorge Elian Agamez Fuentes*, Carlos Alberto Rendon Villa Lobo, Vanesa Paola Lopez Zabaleta and Melisa Andrea Posada Bustos

November 11, 2026

Abstract

Acute appendicitis remains one of the leading causes of surgical acute abdomen and one of the most common surgical emergencies in adults. Although laparoscopic appendectomy remains the standard surgical treatment, recent years have seen a significant shift toward more individualized diagnostic and therapeutic strategies. The combined use of clinical scores, biomarkers, and diagnostic imaging can improve risk stratification and reduce negative appendectomies. Computed tomography plays a central role in adults when the initial clinical assessment does not establish the diagnosis, while ultrasound remains a useful tool, particularly when radiation exposure should be avoided. From a therapeutic standpoint, recent evidence supports the possibility of delaying appendectomy for up to 24 hours in selected patients with uncomplicated disease, without a significant increase in adverse outcomes. Antibiotic treatment is also a reasonable alternative for carefully selected patients with uncomplicated appendicitis, provided that adequate imaging assessment and follow-up are available. However, the presence of an appendicolith is associated with a higher likelihood of failure of conservative treatment and complications. In complicated disease, management should be individualized according to perforation, abscess, clinical status, and the feasibility of source control. This review examines the main advances in the contemporary diagnosis and treatment of acute appendicitis in adults.

Keywords: acute appendicitis; appendectomy; computed tomography; ultrasound; antibiotic treatment; laparoscopic surgery

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