Abstract
<jats:p>Acute Appendicitis is the most common abdominal surgical emergency, both in paediatric and adult population. Diagnosis is still a challenge, as the traditional clinical picture is present in only 60 % of the cases. Children are particularly difficult to evaluate. Morbidity and mortality rise with appendicular perforation. In contrast, the appendectomy of a non-inflamed appendix has also complications. Surgeons are faced with a two-edge sword: misdiagnosis with unnecessary laparotomies and late diagnosis, which can lead to perforation. Moreover, in a subset of patients with acute appendicitis, conservative treatment can be a choice, which is why it is fundamental to make a correct diagnosis. The diagnosis of acute appendicitis, and indeed its complications, relies on a synthesis of clinical history, physical examination, biochemical parameters, and imaging. Biomarkers are quantifiable biomolecules that can used to detect either a normal or pathological biological process. Biomarkers provide objective, non-invasive data to augment clinical assessment and confirm the presence of inflammation, while imaging provides anatomic localisation. Laboratory tests are easily available and performed in primary care settings and help in the decision-making diagnosis of appendicitis. While no single biomarker has sufficient diagnostic accuracy for isolated use, simultaneously measurement of several biomarkers in a single sample can improve diagnostic precision. The ideal biomarker maximises clinical utility while minimising cost and providing rapid turnaround. Understanding the physiopathology of acute appendicitis is fundamental to integrate the information and research on biomarkers. This chapter reviews current evidence on biomarkers related to allergy and explores emerging strategies that incorporate artificial intelligence.</jats:p>