Appendicitis Updated Review

The immunocompromised state alters the normal response to acute infection and wound healing. Appendicitis affects all types of patients and must be considered in those who have undergone organ transplantation, are receiving chemotherapy, have hematological malignancy, or are infected with the human immunodeficiency virus. The differential diagnosis of abdominal pain in this population is broad and includes hepatitis, pancreatitis (from medications or cytomegalovirus infection), acalculous cholecystitis, intra-abdominal opportunistic infections (cytomegalovirus colitis or mycobacterial ileitis), secondary malignancies (lymphoma or Kaposi’s sarcoma), graft-versus-host disease, and typhlitis. This broad differential diagnosis often results in delay in diagnosis and late presentation to surgical evaluation, at which time perforation may be more likely.