Concurrent Acute Appendicitis and Cholecystitis: A Systematic Literature Review

Area of Science:

• Gastroenterology and Hepatology
• Surgical Oncology
• Abdominal Surgery

Background:

• Synchronous acute cholecystitis (AC) and acute appendicitis (AAP) represent a rare clinical presentation.
• Accurate diagnosis and timely management are crucial due to potential complications.

Purpose of the Study:

• To systematically review and evaluate the clinical, diagnostic, and therapeutic characteristics of patients with concurrent AC and AAP.
• To identify optimal diagnostic and management strategies for this rare condition.

Main Methods:

• Systematic literature search across multiple databases (PubMed, MEDLINE, Web of Science, Scopus, Google Scholar) from 1975 to 2025.
• Inclusion of studies with patient-level clinical data on synchronous AC and AAP.
• Data extraction and quality assessment by independent reviewers following PRISMA 2020 guidelines.

Main Results:

• 44 articles were included, analyzing data from 40 patients (median age 41).
• Leukocytosis was common (25/33); ultrasonography and CT were primary diagnostic tools.
• Laparoscopic cholecystectomy and appendectomy were performed in 27 patients, with low complication rates. Histopathology confirmed AAP in 25 and AC in 14 cases.

Conclusions:

• Synchronous AC and AAP are rare and diagnostically challenging, necessitating early recognition through imaging and clinical assessment.
• Laparoscopic surgical management is the preferred approach.
• Histopathological examination of surgical specimens is vital for detecting unexpected findings and guiding patient care.