Foreword

Acute appendicitis affects 7% of the world's population, with 1% of those affected undergoing appendectomy. Mortality from appendicitis is 0.3% and increases to more than 1.5% in complicated forms of the disease. Although prevalent in young patients, appendicitis also occurs in the elderly, with clinical pictures that are often difficult to diagnose.

About 60,000 appendectomies are performed in Italy every year. The risk of serious complications, such as peritonitis, leads to an increase in the number of operations, with the risk of unnecessary appendectomies, up to 20-30% of cases. Hence the need to improve diagnosis. From the classic, simple evaluation of symptoms and objectivity, healthcare professionals today use more rigorous methods to diagnosis appendicitis, including Alvarado score and preoperative imaging diagnostics such as ultrasound, which is simple to perform, inexpensive, and has a diagnostic accuracy of up to 90% when used properly.

I am happy to present this volume edited by Dr. Angelo Guttadauro and written by experts from around the globe. Chapters examine and discuss the diagnosis of acute appendicitis as well as interventions and surgical tactics. This book is a useful reference for gastroenterologists and surgeons.

> **Francesco Gabrielli** Professor, Full Professor in General Surgery, University of Milano-Bicocca, Italy

Section 1 Introduction

### **Chapter 1**
