[Skip to Content]
[Skip to Content Landing]
Views 391
Citations 0
Invited Commentary
March 4, 2020

Acute Appendicitis Incidence—Predisposing Factors, From Microbiota to Socioeconomic Status?

Author Affiliations
  • 1Department of Surgery, University of Turku, Turku, Finland
  • 2Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland
  • 3Satakunta Central Hospital, Pori, Finland
JAMA Surg. Published online March 4, 2020. doi:10.1001/jamasurg.2019.6031

Acute appendicitis is actually 2 different diseases; uncomplicated and complicated appendicitis differ both epidemiologically and clinically, indicating different pathophysiology. The previous line of thinking that appendicitis invariably progresses to perforation has resulted in the surgical dogma for emergency appendectomy for all patients. This has been refuted by the fact that most cases are of an uncomplicated nature, which may be successfully treated with antibiotics1 or perhaps even symptomatic therapy,2,3 avoiding unnecessary surgery and the associated morbidity and increased treatment costs.4 Despite high incidence of appendicitis, there are very few studies on causative mechanisms and pathophysiology, especially ones focusing on the possible differences between uncomplicated and complicated appendicitis.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words