Complicated Appendicitis: An Update

Complicated appendicitis is often used to indicate perforated appendicitis, but it is also used to include an appendicular mass and abscess. There is a lot of controversy from the definition of complicated appendicitis to its management. The management of complicated appendicitis was conservative treatment with intra-venous antibiotics and fluids followed by an interval appendectomy in 8 weeks’ time. With the introduction of laparoscopic appendectomy there has been a shift towards immediate appendectomy. There is no consensus on what the best management of complicated appendicitis is and often its management is decided upon by the operating surgeon. In this chapter, after reviewing the literature, we will discuss the definition, the role of conservative therapy, percutaneous drainage, the role of interval appendectomy and immediate appendectomy.