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Vol. 3 No. 1 (2026)

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November 7, 2026
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November 7, 2026

Copyright (c) 2026 Faisal Ayidh Alanazi, Fares Zaban Alrowiliy, Bader Abd Helal Al Hazmi, Saleh Ashwi Alshammari, Yasir Hadi Alanzi, Abdulmajeed Obaid Alanazi, Ali Eid Altuwayrish, Lutfi Qayyadh Mutairan Alhazmi, Eid Salem Alhazmi, Hussain Ahmed Kariri, Roqiyah Hadi Mohammed Kariri

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Acute Appendicitis in Adults: Diagnosis, Emergency Assessment, and Management-An Updated Review for Medical Emergency Professionals.

https://doi.org/10.64483/202631816
Faisal Ayidh Alanazi
Saudi Red Crescent Authority, Northern Borders Branch, Third Sector, Waad Al Shamal Ambulance Center, Saudi Arabia
Fares Zaban Alrowiliy
Saudi Red Crescent Authority, Northern Borders Branch, Third Sector, Turaif, Saudi Arabia
Bader Abd Helal Al Hazmi
Saudi Red Crescent Authority, Waad Al Shamal Ambulance Center, Turaif, Saudi Arabia
Saleh Ashwi Alshammari
Saudi Red Crescent Authority, Northern Borders Branch, Waad Al Shamal Ambulance Center, Third Sector, Saudi Arabia
Yasir Hadi Alanzi
Saudi Red Crescent Authority, Waad Al Shamal Ambulance Center, Turaif, Saudi Arabia
Abdulmajeed Obaid Alanazi
Saudi Red Crescent Authority, Waad Al Shamal Ambulance Center, Turaif, Saudi Arabia
Ali Eid Altuwayrish
Saudi Red Crescent Authority, Northern Borders Branch, Third Sector, Turaif Ambulance Center, Saudi Arabia
Lutfi Qayyadh Mutairan Alhazmi
Saudi Red Crescent Authority, Northern Borders Branch, Third Sector, Turaif, Saudi Arabia
Eid Salem Alhazmi
Saudi Red Crescent Authority, Northern Borders Branch, Turaif Ambulance Center, Third Sector, Saudi Arabia
Hussain Ahmed Kariri
Samtah General Hospital, Jazan, Ministry of Health – Jazan Health Cluster, Saudi Arabia
Roqiyah Hadi Mohammed Kariri
Samtah General Hospital, Jazan, Ministry of Health – Jazan Health Cluster, Saudi Arabia

Corresponding Author(s) : Faisal Ayidh Alanazi

faisal.alanazi2253@gmail.com

Saudi Journal of Medicine and Public Health, Vol. 3 No. 1 (2026)

Abstract

Background: Acute appendicitis is a cause of acute abdominal pain and remains an indication for emergency surgical assessment. Delayed diagnosis can lead to perforation and other complications, whereas overdiagnosis may lead to unnecessary imaging or surgery.


Aim: This review summarizes the clinical assessment, diagnostic investigations, risk stratification, imaging approaches, and treatment options for acute appendicitis in adults.


Methods: The review discusses evidence and recommendations presented in the cited literature and clinical guidelines, focusing on history and physical examination, laboratory testing, clinical scores, imaging modalities, and the choice between antibiotic treatment and appendectomy.


Results: Diagnosis relies on integrating symptom patterns and examination findings with laboratory and imaging results. Migration of pain to the right lower quadrant and localized tenderness support the diagnosis, but no single clinical feature or laboratory marker is sufficient to confirm or exclude appendicitis. Risk scores, including the Appendicitis Inflammatory Response score and Adult Appendicitis Score, help classify patients and guide further assessment. Computed tomography provides high diagnostic accuracy in adults, while ultrasonography is useful as an initial radiation-free test and magnetic resonance imaging is relevant during pregnancy. Appendectomy remains a treatment. Antibiotic-only management may be considered for selected patients with uncomplicated appendicitis, especially in the absence of an appendicolith, after discussion of treatment failure and recurrence risks. Complicated disease requires individualized management, including antibiotics, drainage when appropriate, or surgery.


Conclusion: Accurate assessment requires a structured, risk-based approach that combines clinical findings, laboratory tests, and appropriate imaging. Treatment should reflect disease severity, patient characteristics, and informed patient preferences.

Keywords

Acute appendicitis; diagnosis; clinical assessment; risk stratification; imaging; appendectomy; antibiotic therapy.
Alanazi, F. A., Alrowiliy, F. Z., Al Hazmi, B. A. H., Alshammari, S. A., Alanzi, Y. H., Alanazi, A. O., … Kariri, R. H. M. (2026). Acute Appendicitis in Adults: Diagnosis, Emergency Assessment, and Management-An Updated Review for Medical Emergency Professionals . Saudi Journal of Medicine and Public Health, 3(1), 266–279. https://doi.org/10.64483/202631816
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