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Review
. 2024 Jun;14(2):84-90.
doi: 10.1016/j.afjem.2024.03.006. Epub 2024 Apr 8.

Is non-operative treatment of acute appendicitis possible: A narrative review

Hani Bendib  1   2
Affiliations
Review

Is non-operative treatment of acute appendicitis possible: A narrative review

Hani Bendib. Afr J Emerg Med. 2024 Jun.

Abstract

Introduction: Acute appendicitis (AA) represents the most frequent surgical emergency. Perforation was long considered the ultimate outcome of AA, prompting appendectomy; which remains the standard treatment. New data have clarified the role of the appendix, justifying conservative treatment. This narrative review aims to summarize the evidence regarding the non-operative treatment (NOT) of AA in adults.

Methods: The literature search was performed via the PubMed Medline database. Our criteria-based selection resulted in a total of 48 articles for review.

Results: Recent trials and meta-analyses have assessed NOT, which support primary antibiotic treatment of uncomplicated AA. Although it has a significant recurrence and failure rate, NOT does not appear to increase the risk of appendicular perforation. Moreover, NOT compared with appendectomy, seems to be associated with less morbidity, lower cost of care and preserved quality of life.

Conclusion: First-line NOT seems to be a reasonable approach for the treatment of uncomplicated CT-confirmed AA. Careful patient screening would definitely enhance the success rate.

Keywords: Acute appendicitis; Antibiotic therapy; Appendectomy; Conservative; Review; Treatment.

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Conflict of interest statement

The author declared no conflicts of interest.

Figures

Fig 1:
Fig. 1
Flowchart describing the article selection process.
See this image and copyright information in PMC

References

    1. Di Saverio S., Podda M., De Simone B., Ceresoli M., Augustin G., Gori A., et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg. 2020;15:27. - PMC - PubMed
    1. Bhangu A., Søreide K., Di Saverio S., Assarsson J.H., Drake F.T. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015;386(10000):1278‑87. - PubMed
    1. Gomes C.A., Abu-Zidan F.M., Sartelli M., Coccolini F., Ansaloni L., Baiocchi G.L., et al. Management of appendicitis globally based on income of countries (MAGIC) study. World J Surg. 2018;42(12):3903‑10. - PubMed
    1. Snyder M.J., Guthrie M., Cagle S. Acute Appendicitis: Efficient Diagnosis and Management. 2018;98(1):10. - PubMed
    1. Jaschinski T., Mosch C., Eikermann M., Neugebauer E.A. Laparoscopic versus open appendectomy in patients with suspected appendicitis: a systematic review of meta-analyses of randomised controlled trials. BMC Gastroenterol. 2015;15:48. - PMC - PubMed

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