Approach to the patient with delayed presentation of suspected appendicitis

Resuscitation, antibiotics, to OR for source control

Diffuse peritonitis present

Yes

No

End

Treat as indicated

CT

Other diagnosis

Appendicitis confirmed

Antibiotics

Abscess

Phlegmon

Laparoscopic drainage, antibiotics

CT drainage feasible

Yes

No

CT drainage, antibiotics

Consider interval appendectomy

Adult

Child

Follow algorithm for appendiceal neoplasm

Consider interval appendectomy

Colonoscopy after discharge

Normal

Neoplasm