Table 1: Comprehensive classification of severity and suggested management of acute appendicitis.

Stage 1

Stage 2

Stage 3

Stage 4

Stage 5

• Acute appendicitis without perforation

a. Erythematous, edematous

b. Absceded

c. Necrotic

• Acute perforated appendicitis with localized abscess

• Perforated acute appendicitis with generalized purulent peritonitis

• Perforated acute appendicitis with generalized purulent peritonitis + free fecaliths

• Acute perforated appendicitis with generalized peritonitis and ileal or cecal necrosis

Suggested

handling

Suggested

handling

Suggested

handling

Suggested

handling

Suggested

handling

• Appendectomy and drying

• Appendectomy, drying and drainage

• Appendectomy, cavity lavage (without drainage)

• Appendectomy + exhaustive lavage and new systematic laparotomy within 48 hours according to the intervention criteria

• Appendectomy + right hemicolectomy with and/or ileal de-functionalization + exhaustive lavage and new systematic laparotomy within 48 hours according to reintervention criteria

1

2

3

4

5

Source: Study data.