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Table 1: Comprehensive classification of severity and suggested management of acute appendicitis. |
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Stage 1 |
Stage 2 |
Stage 3 |
Stage 4 |
Stage 5 |
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• Acute appendicitis without perforation a. Erythematous, edematous b. Absceded c. Necrotic |
• Acute perforated appendicitis with localized abscess |
• Perforated acute appendicitis with generalized purulent peritonitis |
• Perforated acute appendicitis with generalized purulent peritonitis + free fecaliths |
• Acute perforated appendicitis with generalized peritonitis and ileal or cecal necrosis |
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Suggested handling |
Suggested handling |
Suggested handling |
Suggested handling |
Suggested handling |
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• Appendectomy and drying |
• Appendectomy, drying and drainage |
• Appendectomy, cavity lavage (without drainage) |
• Appendectomy + exhaustive lavage and new systematic laparotomy within 48 hours according to the intervention criteria |
• Appendectomy + right hemicolectomy with and/or ileal de-functionalization + exhaustive lavage and new systematic laparotomy within 48 hours according to reintervention criteria |
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1 |
2 |
3 |
4 |
5 |
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Source: Study data. |
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