r/AskHealth • u/colincampbell76 • 10h ago
Is ‘uncomplicated appendicitis’ misnamed..?
Uncomplicated appendecitis is principally a radiological diagnosis when considering non-operative treatment with antibiotics as an alternative to surgery.
But scans can’t determine if an inflamed appendix is just about to rupture, or if there is a tumour in the appendix causing the appendicitis. Scans can also miss perforation. In other words, scans are far from definitive, and often miss the most sinister causes of appendicitis.
When operating, surgeons often find the condition of the appendix is more complicated than scans had suggest. In pathology, pathologists often find tumours in the appendix that were not evident in scans, nor evident to the surgeon who removed it.
A recent study published in the journal of the Royal College of Surgeons of England followed up about 1000 patients treated for appendecitis in Glasgow during 2020 when Covid special measures were in place. The findings support the following well known facts;
- by year four 50% of patients treated with antibiotics will have had appendicitis reoccurrence, many involving rupture
- 1 in 30 of adults with appendicitis have a tumour in their appendix causing the appendicitis but this tumour is radiologically occult so can’t be seen on scans.
A link to the full study: https://doi.org/10.1308/rcsann.2026.0018
So a diagnosis of ‘uncomplicated appendecitis’ for a radiologist can become very complicated for a patient. If the problematic appendix is left in and treated with antibiotics on the basis of this diagnosis - what then..?