{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T21:56:28Z","timestamp":1781214988055,"version":"3.54.1"},"reference-count":93,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Emergency Medicine"],"published-print":{"date-parts":[[2025,12]]},"DOI":"10.1016\/j.ajem.2025.09.007","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:13:45Z","timestamp":1757031225000},"page":"262-268","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"special_numbering":"C","title":["Emergency medicine updates: Acute appendicitis in the adult patient"],"prefix":"10.1016","volume":"98","author":[{"given":"Brit","family":"Long","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Gottlieb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajem.2025.09.007_bb0005","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.jemermed.2020.06.002","article-title":"Association of pain location with computed tomography abnormalities in emergency department patients with abdominal pain","volume":"59","author":"Morley","year":"2020","journal-title":"J Emerg Med"},{"key":"10.1016\/j.ajem.2025.09.007_bb0010","doi-asserted-by":"crossref","first-page":"362","DOI":"10.21037\/atm.2016.09.10","article-title":"Epidemiology and outcomes of acute abdominal pain in a large urban emergency department: retrospective analysis of 5,340 cases","volume":"4","author":"Cervellin","year":"2016","journal-title":"Ann Transl Med"},{"issue":"1","key":"10.1016\/j.ajem.2025.09.007_bb0015","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13017-020-00306-3","article-title":"Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines","volume":"15","author":"Di Saverio","year":"2020","journal-title":"World J Emerg Surg"},{"issue":"3","key":"10.1016\/j.ajem.2025.09.007_bb0020","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.ijsu.2012.02.006","article-title":"Diagnosis of acute appendicitis","volume":"10","author":"Petroianu","year":"2012","journal-title":"Int. J. Surg."},{"key":"10.1016\/j.ajem.2025.09.007_bb0025","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1097\/01.sla.0000256391.05233.aa","article-title":"Disconnect between incidence of nonperforated and perforated appendicitis: implications for pathophysiology and management","volume":"245","author":"Livingston","year":"2007","journal-title":"Ann. Surg."},{"key":"10.1016\/j.ajem.2025.09.007_bb0030","doi-asserted-by":"crossref","first-page":"4037","DOI":"10.3748\/wjg.v20.i14.4037","article-title":"Seasonal variations of acute appendicitis and nonspecific abdominal pain in Finland","volume":"20","author":"Ilves","year":"2014","journal-title":"WJG"},{"key":"10.1016\/j.ajem.2025.09.007_bb0035","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1093\/fampra\/cmu036","article-title":"Studies of the symptom abdominal pain--a systematic review and meta-analysis","volume":"31","author":"Viniol","year":"2014","journal-title":"Fam. Pract."},{"issue":"10000","key":"10.1016\/j.ajem.2025.09.007_bb0040","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/S0140-6736(15)00275-5","article-title":"Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management [published correction appears in Lancet. 2017 Oct 14;390(10104):1736]","volume":"386","author":"Bhangu","year":"2015","journal-title":"Lancet"},{"issue":"3","key":"10.1016\/j.ajem.2025.09.007_bb0045","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1097\/TA.0000000000004569","article-title":"Evidence-based, cost-effective management of acute appendicitis: an algorithm of the journal of trauma and acute care surgery emergency general surgery algorithms work group","volume":"98","author":"Diaz","year":"2025","journal-title":"J. Trauma Acute Care Surg."},{"issue":"6","key":"10.1016\/j.ajem.2025.09.007_bb0050","doi-asserted-by":"crossref","first-page":"2974","DOI":"10.1007\/s00464-024-10813-y","article-title":"SAGES guideline for the diagnosis and treatment of appendicitis","volume":"38","author":"Kumar","year":"2024","journal-title":"Surg. Endosc."},{"key":"10.1016\/j.ajem.2025.09.007_bb0055","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13017-018-0179-0","article-title":"Prospective observational study on acute appendicitis worldwide (POSAW)","volume":"13","author":"Sartelli","year":"2018","journal-title":"World J Emerg Surg"},{"issue":"1","key":"10.1016\/j.ajem.2025.09.007_bb0060","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13017-020-00298-0","article-title":"The SIFIPAC\/WSES\/SICG\/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)","volume":"15","author":"Fugazzola","year":"2020","journal-title":"World J Emerg Surg"},{"issue":"5","key":"10.1016\/j.ajem.2025.09.007_bb0065","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1001\/archsurg.136.5.556","article-title":"Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis","volume":"136","author":"Lee","year":"2001","journal-title":"Arch. Surg."},{"issue":"19","key":"10.1016\/j.ajem.2025.09.007_bb0070","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1001\/jama.1996.03540190061030","article-title":"Does this patient have appendicitis?","volume":"276","author":"Wagner","year":"1996","journal-title":"JAMA"},{"issue":"1","key":"10.1016\/j.ajem.2025.09.007_bb0075","first-page":"11","article-title":"Assessment of peritonism in appendicitis","volume":"78","author":"Golledge","year":"1996","journal-title":"Ann. R. Coll. Surg. Engl."},{"issue":"2","key":"10.1016\/j.ajem.2025.09.007_bb0080","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/PL00013174","article-title":"Diagnostic value of disease history, clinical presentation, and inflammatory parameters of appendicitis","volume":"23","author":"Andersson","year":"1999","journal-title":"World J. Surg."},{"issue":"2","key":"10.1016\/j.ajem.2025.09.007_bb0085","first-page":"128","article-title":"A useful sign for the diagnosis of peritoneal irritation in the right iliac fossa","volume":"79","author":"Lane","year":"1997","journal-title":"Ann. R. Coll. Surg. Engl."},{"issue":"2","key":"10.1016\/j.ajem.2025.09.007_bb0090","first-page":"255","article-title":"Acute appendicitis in pregnancy: 50 case series, maternal and neonatal outcomes. Gebelikte akut apandisit: 50 olgu serisi, maternal ve neonatal sonu\u00e7lar\u0131","volume":"27","author":"Tanr\u0131dan Okcu","year":"2021","journal-title":"Ulus Travma Acil Cerrahi Derg"},{"issue":"2","key":"10.1016\/j.ajem.2025.09.007_bb0095","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1590\/1806-9282.61.02.170","article-title":"Acute appendicitis in pregnancy: literature review","volume":"61","author":"Franca Neto","year":"2015","journal-title":"Rev Assoc Med Bras (1992)"},{"issue":"3","key":"10.1016\/j.ajem.2025.09.007_bb0100","doi-asserted-by":"crossref","first-page":"93","DOI":"10.3390\/geriatrics6030093","article-title":"Acute appendicitis in the elderly: a literature review on an increasingly frequent surgical problem","volume":"6","author":"Lapsa","year":"2021","journal-title":"Geriatrics (Basel)"},{"issue":"4","key":"10.1016\/j.ajem.2025.09.007_bb0105","first-page":"224","article-title":"Differences in the clinical course of acute appendicitis in geriatric patient groups","volume":"8","author":"Er","year":"2020","journal-title":"Bull Emerg Trauma"},{"issue":"3","key":"10.1016\/j.ajem.2025.09.007_bb0110","first-page":"17","article-title":"The role of white cell count and C-reactive protein in the diagnosis of acute appendicitis","volume":"16","author":"Khan","year":"2004","journal-title":"J Ayub Med Coll Abbottabad"},{"issue":"1\u20132","key":"10.1016\/j.ajem.2025.09.007_bb0115","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/j.1445-2197.2006.03645.x","article-title":"Laboratory tests in patients with acute appendicitis","volume":"76","author":"Yang","year":"2006","journal-title":"ANZ J. Surg."},{"issue":"4","key":"10.1016\/j.ajem.2025.09.007_bb0120","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1177\/000313480507100414","article-title":"Role of leukocyte count, neutrophil percentage, and C-reactive protein in the diagnosis of acute appendicitis in the elderly","volume":"71","author":"Yang","year":"2005","journal-title":"Am. Surg."},{"issue":"8","key":"10.1016\/j.ajem.2025.09.007_bb0125","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1007\/s00268-008-9649-y","article-title":"The appendicitis inflammatory response score: a tool for the diagnosis of acute appendicitis that outperforms the Alvarado score","volume":"32","author":"Andersson","year":"2008","journal-title":"World J. Surg."},{"issue":"1","key":"10.1016\/j.ajem.2025.09.007_bb0130","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s13017-025-00582-x","article-title":"Diagnostic value of the appendicitis inflammatory response (AIR) score. A systematic review and meta-analysis","volume":"20","author":"Andersson","year":"2025","journal-title":"World J Emerg Surg"},{"issue":"1092","key":"10.1016\/j.ajem.2025.09.007_bb0135","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1136\/postgradmedj-2015-133865","article-title":"The clinical value of pathology tests and imaging study in the diagnosis of acute appendicitis","volume":"92","author":"Chen","year":"2016","journal-title":"Postgrad. Med. J."},{"key":"10.1016\/j.ajem.2025.09.007_bb0140","article-title":"Acute appendicitis","volume":"357","author":"Baird","year":"2017","journal-title":"BMJ"},{"issue":"5","key":"10.1016\/j.ajem.2025.09.007_bb0145","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/S0196-0644(86)80993-3","article-title":"A practical score for the early diagnosis of acute appendicitis","volume":"15","author":"Alvarado","year":"1986","journal-title":"Ann. Emerg. Med."},{"issue":"2","key":"10.1016\/j.ajem.2025.09.007_bb0150","first-page":"169","article-title":"ART\u00cdCULO ORIGINAL An\u00e1lisis comparativo de escalas diagn\u00f3sticas de apendicitis aguda: Alvarado, RIPASA y AIR [comparative analysis of diagnostic scales of acute appendicitis: Alvarado, RIPASA and AIR]","volume":"86","author":"Bol\u00edvar-Rodr\u00edguez","year":"2018","journal-title":"Cir Cir"},{"issue":"14","key":"10.1016\/j.ajem.2025.09.007_bb0155","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.sopen.2023.07.007","article-title":"Adult appendicitis score versus Alvarado score: a comparative study in the diagnosis of acute appendicitis","author":"Ghali","year":"2023","journal-title":"Surg Open Sci"},{"issue":"3","key":"10.1016\/j.ajem.2025.09.007_bb0160","first-page":"220","article-title":"Development of the RIPASA score: a new appendicitis scoring system for the diagnosis of acute appendicitis","volume":"51","author":"Chong","year":"2010","journal-title":"Singapore Med. J."},{"issue":"3","key":"10.1016\/j.ajem.2025.09.007_bb0165","doi-asserted-by":"crossref","first-page":"203","DOI":"10.4103\/MJBL.MJBL_48_19","article-title":"The modified Alvarado score versus Alvarado score in the diagnosis of acute appendicitis","volume":"16","author":"Sulo","year":"2019","journal-title":"Med. J. Babylon"},{"issue":"9","key":"10.1016\/j.ajem.2025.09.007_bb0170","doi-asserted-by":"crossref","first-page":"e0275427.z","DOI":"10.1371\/journal.pone.0275427","article-title":"Comparison of RIPASA and ALVARADO scores for risk assessment of acute appendicitis: a systematic review and meta-analysis","volume":"17","author":"Favara","year":"2022","journal-title":"PLoS One"},{"key":"10.1016\/j.ajem.2025.09.007_bb0175","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.ijsu.2018.07.003","article-title":"Alvarado or RIPASA score for diagnosis of acute appendicitis? A meta-analysis of randomized trials","volume":"56","author":"Frountzas","year":"2018","journal-title":"Int. J. Surg."},{"issue":"11S","key":"10.1016\/j.ajem.2025.09.007_bb0185","first-page":"S445","article-title":"ACR appropriateness criteria\u00ae right lower quadrant pain: 2022 update","volume":"19","author":"Expert Panel on Gastrointestinal Imaging","year":"2022","journal-title":"J. Am. Coll. Radiol."},{"issue":"11","key":"10.1016\/j.ajem.2025.09.007_bb0190","article-title":"Computed tomography for diagnosis of acute appendicitis in adults","volume":"2019","author":"Rud","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"10.1016\/j.ajem.2025.09.007_bb0195","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.annemergmed.2009.06.509","article-title":"Diagnostic accuracy of noncontrast computed tomography for appendicitis in adults: a systematic review","volume":"55","author":"Hlibczuk","year":"2010","journal-title":"Ann. Emerg. Med."},{"issue":"9","key":"10.1016\/j.ajem.2025.09.007_bb0200","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1016\/j.ajem.2012.02.011","article-title":"Intravenous contrast alone vs intravenous and oral contrast computed tomography for the diagnosis of appendicitis in adult ED patients","volume":"30","author":"Kepner","year":"2012","journal-title":"Am. J. Emerg. Med."},{"issue":"5","key":"10.1016\/j.ajem.2025.09.007_bb0205","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.2214\/AJR.09.3313","article-title":"CT protocols for acute appendicitis: time for change","volume":"193","author":"Paulson","year":"2009","journal-title":"AJR Am. J. Roentgenol."},{"issue":"17","key":"10.1016\/j.ajem.2025.09.007_bb0210","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1056\/NEJMoa1110734","article-title":"Low-dose abdominal CT for evaluating suspected appendicitis","volume":"366","author":"Kim","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.ajem.2025.09.007_bb0215","article-title":"The accuracy of low-dose computed tomography protocol in patients with suspected acute appendicitis: the OPTICAP study","volume":"1","author":"Sippola","year":"2018","journal-title":"Ann. Surg."},{"issue":"8","key":"10.1016\/j.ajem.2025.09.007_bb0220","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1016\/j.acra.2008.02.009","article-title":"Independent predictors of acute appendicitis on CT with pathologic correlation","volume":"15","author":"Ives","year":"2008","journal-title":"Acad. Radiol."},{"issue":"6","key":"10.1016\/j.ajem.2025.09.007_bb0225","doi-asserted-by":"crossref","first-page":"2876","DOI":"10.1177\/00031348211054076","article-title":"Features on computed tomography that correlate with acute appendicitis","volume":"89","author":"Cho","year":"2023","journal-title":"Am. Surg."},{"key":"10.1016\/j.ajem.2025.09.007_bb0230","first-page":"633","article-title":"Diagnostic value of ultrasonography in appendicitis","volume":"21","author":"Sezer TO","year":"2012","journal-title":"Adv. Clin. Exp. Med."},{"key":"10.1016\/j.ajem.2025.09.007_bb0235","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.clinimag.2015.01.011","article-title":"Accuracy of bedside emergency physician performed ultrasound in diagnosing different causes of acute abdominal pain: a prospective study","volume":"39","author":"Hasani","year":"2015","journal-title":"Clin. Imaging"},{"key":"10.1016\/j.ajem.2025.09.007_bb0240","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1148\/radiol.2018180318","article-title":"Acute appendicitis: a Meta-analysis of the diagnostic accuracy of US, CT, and MRI as second-line Imaging tests after an initial US","volume":"288","author":"Eng","year":"2018","journal-title":"Radiology"},{"key":"10.1016\/j.ajem.2025.09.007_bb0245","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1016\/j.ultrasmedbio.2014.02.014","article-title":"False-negative appendicitis at ultrasound: nature and association","volume":"40","author":"Piyarom","year":"2014","journal-title":"Ultrasound Med. Biol."},{"key":"10.1016\/j.ajem.2025.09.007_bb0250","doi-asserted-by":"crossref","first-page":"66","DOI":"10.26719\/2012.18.1.66","article-title":"Sensitivity and specificity of ultrasound in the diagnosis of acute appendicitis","volume":"18","author":"Al-Ajerami","year":"2012","journal-title":"East Mediterr. Health J."},{"key":"10.1016\/j.ajem.2025.09.007_bb0255","doi-asserted-by":"crossref","first-page":"2365","DOI":"10.1007\/s00464-014-3963-2","article-title":"Less negative appendectomies due to imaging in patients with suspected appendicitis","volume":"29","author":"Boonstra","year":"2015","journal-title":"Surg. Endosc."},{"key":"10.1016\/j.ajem.2025.09.007_bb0260","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1016\/j.ultrasmedbio.2015.01.021","article-title":"Body mass index, pain score and Alvarado score are useful predictors of appendix visualization at ultrasound in adults","volume":"41","author":"Kaewlai","year":"2015","journal-title":"Ultrasound Med. Biol."},{"key":"10.1016\/j.ajem.2025.09.007_bb0265","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/j.clinimag.2016.03.012","article-title":"The current utility of ultrasound in the diagnosis of acute appendicitis","volume":"40","author":"Lourenco","year":"2016","journal-title":"Clin. Imaging"},{"key":"10.1016\/j.ajem.2025.09.007_bb0270","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1002\/jcu.21928","article-title":"Sonography for appendicitis: nonvisualization of the appendix is an indication for active clinical observation rather than direct referral for computed tomography","volume":"40","author":"Stewart","year":"2012","journal-title":"J. Clin. Ultrasound"},{"key":"10.1016\/j.ajem.2025.09.007_bb0275","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijsu.2019.08.009","article-title":"Bedside ultrasonography for acute appendicitis: an updated diagnostic meta-analysis","volume":"70","author":"Shen","year":"2019","journal-title":"Int. J. Surg."},{"key":"10.1016\/j.ajem.2025.09.007_bb0280","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.2214\/AJR.13.12334","article-title":"Three-step sequential positioning algorithm during sonographic evaluation for appendicitis increases appendiceal visualization rate and reduces CT use","volume":"203","author":"Chang","year":"2014","journal-title":"Am. J. Roentgenol."},{"key":"10.1016\/j.ajem.2025.09.007_bb0285","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1111\/acem.13212","article-title":"Accuracy of point-of-care ultrasonography for diagnosing acute appendicitis: a systematic review and meta analysis","volume":"24","author":"Matthew Fields","year":"2017","journal-title":"Acad. Emerg. Med."},{"key":"10.1016\/j.ajem.2025.09.007_bb0290","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ijsu.2016.08.021","article-title":"The diagnostic performance of ultrasound for acute appendicitis in pregnant and young nonpregnant women: a case-control study","volume":"34","author":"Segev","year":"2016","journal-title":"Int. J. Surg."},{"key":"10.1016\/j.ajem.2025.09.007_bb0295","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s10140-012-1029-0","article-title":"Utility of ultrasound for evaluating the appendix during the second and third trimester of pregnancy","volume":"19","author":"Lehnert","year":"2012","journal-title":"Emerg. Radiol."},{"key":"10.1016\/j.ajem.2025.09.007_bb0300","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/j.jpedsurg.2018.02.028","article-title":"Standardized reporting of appendicitisrelated findings improves reliability of ultrasound in diagnosing appendicitis in children","volume":"53","author":"Sola","year":"2018","journal-title":"J. Pediatr. Surg."},{"key":"10.1016\/j.ajem.2025.09.007_bb0305","doi-asserted-by":"crossref","first-page":"S373","DOI":"10.1016\/j.jacr.2018.09.033","article-title":"ACR appropriateness criteria\u00ae right lower quadrant pain-suspected appendicitis","volume":"15","author":"Garcia","year":"2018","journal-title":"J. Am. Coll. Radiol."},{"key":"10.1016\/j.ajem.2025.09.007_bb0310","first-page":"600","article-title":"Role of emergency magnetic resonance imaging for the workup of suspected appendicitis in pregnant women","volume":"18","author":"Amitai","year":"2016","journal-title":"Isr. Med. Assoc. J."},{"key":"10.1016\/j.ajem.2025.09.007_bb0315","doi-asserted-by":"crossref","first-page":"485","DOI":"10.3109\/14767058.2010.506227","article-title":"MR imaging in cases of antenatal suspected appendicitis \u2013 a meta-analysis","volume":"24","author":"Blumenfeld","year":"2011","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"10.1016\/j.ajem.2025.09.007_bb0320","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1002\/jmri.22854","article-title":"Diagnostic accuracy of magnetic resonance imaging: a prospective evaluation of patients with suspected appendicitis (diamond)","volume":"35","author":"Heverhagen","year":"2012","journal-title":"J. Magn. Reson. Imaging"},{"key":"10.1016\/j.ajem.2025.09.007_bb0325","doi-asserted-by":"crossref","first-page":"3235","DOI":"10.1007\/s00261-019-02180-3","article-title":"Accuracy, criteria, and clinical significance of visual assessment on diffusion-weighted imaging and apparent diffusion coefficient quantification for diagnosing acute appendicitis","volume":"44","author":"Inoue","year":"2019","journal-title":"Abdom Radiol (NY)"},{"key":"10.1016\/j.ajem.2025.09.007_bb0330","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1148\/radiol.2015150468","article-title":"Accuracy of unenhanced MR Imaging in the detection of acute appendicitis: single-institution clinical performance review","volume":"279","author":"Petkovska","year":"2016","journal-title":"Radiology"},{"key":"10.1016\/j.ajem.2025.09.007_bb0335","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.ejrad.2015.10.002","article-title":"Rapid acquisition axial and coronal T2 HASTE MR in the evaluation of acute abdominal pain","volume":"85","author":"Byott","year":"2016","journal-title":"Eur. J. Radiol."},{"key":"10.1016\/j.ajem.2025.09.007_bb0340","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1148\/radiol.13121753","article-title":"Comparison of imaging strategies with conditional contrast-enhanced CT and unenhanced MR imaging in patients suspected of having appendicitis: a multicenter diagnostic performance study","volume":"268","author":"Leeuwenburgh","year":"2013","journal-title":"Radiology"},{"key":"10.1016\/j.ajem.2025.09.007_bb0345","doi-asserted-by":"crossref","first-page":"508","DOI":"10.2214\/AJR.15.14544","article-title":"A systematic review and Meta-analysis of diagnostic performance of MRI for evaluation of acute appendicitis","volume":"206","author":"Duke","year":"2016","journal-title":"AJR Am. J. Roentgenol."},{"key":"10.1016\/j.ajem.2025.09.007_bb0350","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s10140-014-1260-y","article-title":"Evaluation of a sequential multi-modality imaging algorithm for the diagnosis of acute appendicitis in the pregnant female","volume":"22","author":"Ramalingam","year":"2015","journal-title":"Emerg. Radiol."},{"issue":"693","key":"10.1016\/j.ajem.2025.09.007_bb0355","first-page":"e1","article-title":"Magnetic resonance imaging of acute appendicitis in pregnancy: a 5-year multiinstitutional study","volume":"213","author":"Burke","year":"2015","journal-title":"Am. J. Obstet. Gynecol."},{"issue":"345","key":"10.1016\/j.ajem.2025.09.007_bb0360","first-page":"e1","article-title":"Utility of magnetic resonance imaging for suspected appendicitis in pregnant women","volume":"212","author":"Theilen","year":"2015","journal-title":"Am. J. Obstet. Gynecol."},{"key":"10.1016\/j.ajem.2025.09.007_bb0365","doi-asserted-by":"crossref","first-page":"3359","DOI":"10.1007\/s00261-015-0540-7","article-title":"MRI: first-line imaging modality for pregnant patients with suspected appendicitis","volume":"40","author":"Konrad","year":"2015","journal-title":"Abdom. Imaging"},{"key":"10.1016\/j.ajem.2025.09.007_bb0370","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1148\/radiol.12121027","article-title":"Integrating MR imaging into the clinical workup of pregnant patients suspected of having appendicitis is associated with a lower negative laparotomy rate: single-institution study","volume":"267","author":"Rapp","year":"2013","journal-title":"Radiology"},{"key":"10.1016\/j.ajem.2025.09.007_bb0375","author":"American College of Radiology"},{"issue":"3","key":"10.1016\/j.ajem.2025.09.007_bb0380","doi-asserted-by":"crossref","first-page":"195","DOI":"10.2146\/ajhp120568","article-title":"Clinical practice guidelines for antimicrobial prophylaxis in surgery","volume":"70","author":"Bratzler","year":"2013","journal-title":"Am. J. Health Syst. Pharm."},{"issue":"11","key":"10.1016\/j.ajem.2025.09.007_bb0385","doi-asserted-by":"crossref","first-page":"4668","DOI":"10.1007\/s00464-016-5245-7","article-title":"Diagnosis and management of acute appendicitis. EAES consensus development conference 2015","volume":"30","author":"Gorter","year":"2016","journal-title":"Surg. Endosc."},{"key":"10.1016\/j.ajem.2025.09.007_bb0390","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1097\/SLA.0000000000003225","article-title":"Antibiotic treatment and appendectomy for uncomplicated acute appendicitis in adults and children: a systematic review and meta-analysis","volume":"270","author":"Podda","year":"2019","journal-title":"Ann. Surg."},{"issue":"5","key":"10.1016\/j.ajem.2025.09.007_bb0395","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1097\/SLA.0000000000002039","article-title":"Antibiotics versus surgical therapy for uncomplicated appendicitis: systematic review and Meta-analysis of controlled trials (PROSPERO 2015: CRD42015016882)","volume":"265","author":"Harnoss","year":"2017","journal-title":"Ann. Surg."},{"issue":"23","key":"10.1016\/j.ajem.2025.09.007_bb0400","doi-asserted-by":"crossref","first-page":"2340","DOI":"10.1001\/jama.2015.6154","article-title":"Antibiotic therapy vs appendectomy for treatment of uncomplicated acute appendicitis: the APPAC randomized clinical trial","volume":"313","author":"Salminen","year":"2015","journal-title":"JAMA"},{"key":"10.1016\/j.ajem.2025.09.007_bb0405","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1089\/sur.2017.073","article-title":"Antibiotics vs. appendectomy for acute uncomplicated appendicitis in adults: review of the evidence and future directions","volume":"18","author":"Huston","year":"2017","journal-title":"Surg. Infect."},{"issue":"9777","key":"10.1016\/j.ajem.2025.09.007_bb0410","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1016\/S0140-6736(11)60410-8","article-title":"Amoxicillin plus clavulanic acid versus appendicectomy for treatment of acute uncomplicated appendicitis: an open-label, non-inferiority, randomised controlled trial","volume":"377","author":"Vons","year":"2011","journal-title":"Lancet"},{"issue":"1","key":"10.1016\/j.ajem.2025.09.007_bb0415","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.annemergmed.2016.08.446","article-title":"Olive view\u2013UCLA appendicitis study group. Antibiotics-first versus surgery for appendicitis: a US pilot randomized controlled trial allowing outpatient antibiotic management","volume":"70","author":"Talan","year":"2017","journal-title":"Ann. Emerg. Med."},{"issue":"2","key":"10.1016\/j.ajem.2025.09.007_bb0420","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1097\/SLA.0000000000004785","article-title":"A randomized clinical trial evaluating the efficacy and quality of life of antibiotic-only treatment of acute uncomplicated appendicitis: results of the COMMA trial","volume":"274","author":"O\u2019Leary","year":"2021","journal-title":"Ann. Surg."},{"issue":"2","key":"10.1016\/j.ajem.2025.09.007_bb0425","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s13304-018-00614-z","article-title":"Never put equipoise in appendix! Final results of ASAA (antibiotics vs. surgery for uncomplicated acute appendicitis in adults) randomized controlled trial","volume":"71","author":"Ceresoli","year":"2019","journal-title":"Updat. Surg."},{"issue":"25","key":"10.1016\/j.ajem.2025.09.007_bb0430","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.1056\/NEJMc2116018","article-title":"Antibiotics versus appendectomy for acute appendicitis - longer-term outcomes","volume":"385","author":"Collaborative","year":"2021","journal-title":"N. Engl. J. Med."},{"issue":"3","key":"10.1016\/j.ajem.2025.09.007_bb0435","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/S2468-1253(24)00349-2","article-title":"Antibiotic treatment versus appendicectomy for acute appendicitis in adults: an individual patient data meta-analysis","volume":"10","author":"Scheijmans","year":"2025","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"1","key":"10.1016\/j.ajem.2025.09.007_bb0440","doi-asserted-by":"crossref","DOI":"10.1136\/tsaco-2018-000281","article-title":"American Association for the Surgery of Trauma emergency general surgery guideline summaries 2018: acute appendicitis, acute cholecystitis, acute diverticulitis, acute pancreatitis, and small bowel obstruction","volume":"4","author":"Schuster","year":"2019","journal-title":"Trauma Surg Acute Care Open"},{"issue":"1","key":"10.1016\/j.ajem.2025.09.007_bb0445","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1097\/TA.0000000000002270","article-title":"Management of acute appendicitis in adults: a practice management guideline from the eastern Association for the Surgery of trauma","volume":"87","author":"Rushing","year":"2019","journal-title":"J. Trauma Acute Care Surg."},{"key":"10.1016\/j.ajem.2025.09.007_bb0450","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.surge.2017.02.001","volume":"15","author":"Podda","year":"2017","journal-title":"Surgeon"},{"issue":"4","key":"10.1016\/j.ajem.2025.09.007_bb0455","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1001\/jama.2020.23525","article-title":"Effect of Oral moxifloxacin vs intravenous ertapenem plus Oral levofloxacin for treatment of uncomplicated acute appendicitis: the APPAC II randomized clinical trial","volume":"325","author":"Sippola","year":"2021","journal-title":"JAMA"},{"issue":"7","key":"10.1016\/j.ajem.2025.09.007_bb0460","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1001\/jamasurg.2023.5947","article-title":"Three-year outcomes of Oral antibiotics vs intravenous and Oral antibiotics for uncomplicated acute appendicitis: a secondary analysis of the APPAC II randomized clinical trial","volume":"159","author":"Sel\u00e4nne","year":"2024","journal-title":"JAMA Surg"},{"issue":"7","key":"10.1016\/j.ajem.2025.09.007_bb0465","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1001\/jamasurg.2025.1212","article-title":"Role of preoperative antibiotic treatment while awaiting appendectomy: the PERFECT-antibiotics randomized clinical trial","volume":"160","author":"Jalava","year":"2025","journal-title":"JAMA Surg"},{"issue":"7","key":"10.1016\/j.ajem.2025.09.007_bb0470","doi-asserted-by":"crossref","first-page":"3233","DOI":"10.1007\/s00464-021-08524-9","article-title":"EAES rapid guideline: appendicitis in the elderly","volume":"35","author":"Antoniou","year":"2021","journal-title":"Surg. Endosc."}],"container-title":["The American Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735675725006114?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735675725006114?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T22:20:51Z","timestamp":1768429251000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0735675725006114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":93,"alternative-id":["S0735675725006114"],"URL":"https:\/\/doi.org\/10.1016\/j.ajem.2025.09.007","relation":{},"ISSN":["0735-6757"],"issn-type":[{"value":"0735-6757","type":"print"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Emergency medicine updates: Acute appendicitis in the adult patient","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Emergency Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajem.2025.09.007","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}