Appendicitis is the most common abdominal emergency.While the clinical diagnosis may be straightforward
in patients who present with classic signs and symptoms, atypical presentations may result in diagnostic
confusion and delay in treatment. Abdominal pain is the primary presenting complaint of patients with acute
appendicitis. Nausea, vomiting, and anorexia occur in varying degrees. Abdominal examination reveals
localised tenderness and muscular rigidity after localisation of the pain to the right iliac fossa. Laboratory data
upon presentation usually reveal an elevated leukocytosis with a left shift.Measurement of C-reactive protein
is most likely to be elevated. The advances in imaginology trend to diminish the false positive or negative
diagnosis. Radiographic image of faecal loading image in the caecum has a sensitivity of 97% and a negative
predictive value that is 98%. In experienced hands, ultrasound may have a sensitivity of 90% and specificity
higher than 90%. Helical CT has reported a sensitivity that may reach 95% and specificity higher than 95%.
Despite all medical advances, the diagnosis of acute appendicitis continues to be a medical challenge.