Laparoscopic incidence in acute appendicitis related to its degree of severity

Abstract

The exact cause of acute appendicitis remains unknown, being probably multifactorial, but the inflammation of the vermiform appendix, due to luminal obstruction or dietary factors, is a major diagnostic criterion in acute appendicitis. This pathology typically presents acutely within the first 24 hours of onset, but can also present as a more chronic condition. It is currently considered that the pathological process begins after prolonged spasm of the smooth muscles and arterial vessels of the appendix. Muscle contraction leads to stasis in the appendix, spasm of the arterial vessels, ischaemia of the mucosa and, as a consequence, the primary Aschoff complex develops. Acute appendicitis is the most common surgical emergency which required the development of a predictor, represented in many studies by the disease severity score (DSS). This score can be associated with the results on the incidence of in-hospital and after hospital discharge complications, with the evaluation of the duration of hospitalization, in order to apply the most effective therapeutic methods. Once the diagnosis of acute appendicitis has been made, the appendicectomy should be performed urgently within the first hours after hospitalization. To date, the indications for laparoscopic appendicectomy are debatable and its advantages are related to the severity of the disease.