Diagnosis and treatment of Acute Appendicitis 2020 update from WSES Jerusalem Guideline

Abstract

Background: Acute appendicitis is the most common surgical emergency in the emergency department, with an incidence between the ages of 10 and 30 years. Prompt and accurate diagnosis is essential as if left untreated, it can lead to serious complications such as appendicitis rupture or intra-abdominal infection, which can increase mortality. Technological advances and recent guidelines, such as the 2020 WSES Jerusalem Guideline, have played a significant role in improving diagnosis and treatment.

Objective: This study aimed to synthesize updated guidelines for the diagnosis and treatment of acute appendicitis, focusing on a comparison of traditional (surgical) and new (non-surgical treatment with antibiotics) approaches, and to analyze the impact of increasingly popular laparoscopic surgical techniques.

Methodology: The study used a literature review method, analyzing research on the diagnosis and treatment of acute appendicitis, as well as data from the latest WSES clinical guidelines. The study collected data from published scientific articles in medical journals and recognized sources.

Results: The diagnostic guidelines for appendicitis have improved. By using diagnostic tools such as Alvarado Score, AIR Score, and AAS Score, which can reduce the misdiagnosis rate, in addition, imaging technologies such as ultrasound and CT Scan play an important role in confirming the diagnosis. Surgical treatment remains the standard, especially laparoscopic surgery with its advantages of faster recovery and fewer complications. However, non-surgical treatment with antibiotics in the absence of complications has gained more attention because it can reduce the need for surgery and related complications.

Conclusion: Accurate and rapid diagnosis of acute appendicitis is an important factor in reducing the rate of complications and mortality. The use of imaging techniques in conjunction with clinical assessment can improve the efficiency of diagnosis. In terms of treatment, laparoscopic surgery is highly effective, but in some cases, antibiotic treatment may be a suitable option. Modern guidelines should take into account patient-specific factors and the risk of complications.