Criteria of Gorter et al for Complex Appendicitis

 

Patient selection: child with acute appendicitis

 

Features of complex appendicitis include one or more of the following:

(1) clinical signs of a gangrenous appendicitis with or without

(1a) perforation

(1b) intra-abdominal abscess

(1c) periappendicular-contained phlegmon

(1d) purulent-free fluid

(2) need for additional postoperative antibiotics directly after appendectomy not because of peri-operative spillage

(3) histologic evidence of extensive necrosis in the outer layer of the appendix (gangrene)

(4) pathologic evidence of perforation

 

A patient who does not meet the criteria for complex appendicitis has simple appendicitis.