A typical presentation of acute appendicitis consists of right lower quadrant pain, abdominal rigidity and shifting of pain from the periumbilical region to the right lower quadrant (iliac fossa).¹Loss of appetite, nausea and constipationare often present. Profuse vomiting may indicatedevelopment of generalized peritonitis after perforation butis not a common feature in simple appendicitis.

The most important physical finding is right lower quadrant pain on palpation of the abdomen. The site of maximal tenderness is overMcBurney’s point, which lies two-thirds along a linedrawn from the umbilicus to the anterior superior iliac spine. Other findings include low-grade fever, peritoneal signs and guarding. Unusual presentations occur if the patient is young or elderly, in women of childbearing age and when the appendix is not in its normal location.¹        

Written by: Healthplus24 team
Date last updated: December 22,2008

• Management of appendicitis