 Now it's promised the epidemiology of acute appendicitis now in some units It is the most common acute surgical condition certainly here with us It's number two, but still very very common up to one in a thousand people Even more can suffer from acute appendicitis. There is a male predominance Leaving a male with a lifetime risk of about 8.6% and a female with a lifetime risk of about 6.7% There is definitely a high incidence in younger patients teens and twenties That's where we see acute appendicitis Now that doesn't mean it's the only people who get acute appendicitis We still we still definitely see it throughout the age groups The baby's total is very young We think they relatively protected in as much as they have Draw the base of the appendix If you postulate that obstruction might play a part in the pathogenesis of acute appendicitis They'll have better drainage In the older age group we might see that acute appendicitis is underreported But Sydney there's other conditions become more predominant It's not to say though that any age group cannot get appendicitis Always maintain that in your differential diagnosis As far as the geographical areas are concerned Sydney less common in underdeveloped areas We think that diet may play a part in that Diet with a higher fiber content might be slightly protective Now even in this day and age you can still die from acute appendicitis It can be as low as 2 per million patients Even lower than that But there's certainly high incidence of mortality in underdeveloped areas These patients have a delay in presentation Takes longer for them to get to healthcare When they get to healthcare there might be delays in diagnosis Delays on getting on the theatre bed Resources as far as antimicrobial drugs are concerned So definitely higher mortality rate there Also higher at the extremes of age There's definitely physiological reserve issues at the extremes of age And if we think about the older patients Obviously comorbid conditions In the very young and very old There might also be delays due to problems with diagnosis So the messages always think of acute appendicitis and abdominal pain No matter what patient you see