Appendicitis.
BACKGROUND
Potential causes of appendicitis include faecoliths, lymphoid hyperplasia, and caecal carcinoma, all of which can lead to obstruction of the appendix lumen. The lifetime risk is approximately 7-9% in the USA, making appendicectomy the most common abdominal surgical emergency. Mortality from acute appendicitis is less than 0.3%, but rises to 1.7% after perforation.


METHODS
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for acute appendicitis? We searched: Medline, Embase, The Cochrane Library and other important databases up to November 2006 (BMJ Clinical evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 10 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, laparoscopic surgery, ligation, open surgery, stump inversion, surgery.
Humes
David
D
University of Nottingham, Nottingham, UK.
Speake
William James
WJ
Simpson
John
J
D000208:Acute Disease; D001062:Appendectomy; D001064:Appendicitis / Q000601:surgery; D001065:Appendix; D006801:Humans; D007416:Intestinal Perforation / Q000601:surgery; D010535:Laparoscopy; D011446:Prospective Studies