Naeder, S.B.Clegg-Lamptey, J.N.Dakubo, J.C.B.2013-12-092013-12-092013-12-09http://197.255.68.203/handle/123456789/4593There is considerable variation in the incidence of acute appendicitis worldwide. The disease is common in western nations but much less so in developing countries. However recent reports suggest that the incidence of acute appendicitis is declining in the developed world and the reverse is occurring in developing countries. Acute appendicitis is now the leading cause of the acute abdomen in Africa including Ghana and West Africa. The aetiology of acute appendicitis has been attributed to the substitution of high residue diets with refined foods but this hypothesis has been disputed. Appendicular luminal obstruction by a faecolith is thought to initiate the inflammatory changes associated with acute appendicitis as the majority of cases are due to an obstructing faecolith. Diagnosis of acute appendicitis is largely clinical with the symptomatology essentially similar globally. In children, the elderly and pregnancy acute appendicitis may present a formidable diagnostic challenge and therefore a high index of suspicion is required. Sophisticated investigations are not necessary in the majority of cases. However ancillary investigations may be done to improve diagnostic accuracy and minimize the negative appendicectomy rate. The treatment of acute appendicitis is appendicectomy. Prophylactic antibiotics are required in all cases to reduce the incidence of surgical site infection. However in resource-limited settings conservative management with antibiotics may be the only option as the natural history of acute appendicitis includes spontaneous resolution. Recurrence rates following conservative treatment are, however, unacceptably high. Generally mortality and morbidity rates are low in acute appendicitis but are higher in those with complicated appendicitis.enArticle