Context

Appendicitis is one of the commonest surgical problems that present to emergency departments (ED). It accounts for around 40 000 admissions per year in England, mainly in patients between the ages of 15 and 25 years of age [1]. Adults in the Western world have around a 6-8% chance of developing appendicitis in their lives, although the incidence seems to be falling somewhat in recent years [1]. Appendicitis is less common in the developing world.

The mortality of appendicitis rises from 0.8 per 1000 cases to 5.1 per 1000 cases if the appendix perforates [1]. Importantly, up to 10% of appendicitis cases in the US are not picked up on first clinical assessment [2].

Learning bite

Patients are at much higher risk of significant morbidity and mortality if their appendix perforates.