[Time to re-evaluate management of suspected appendicitis. Patients might be spared "unnecessary" surgery]

The management of patients with suspected appendicitis remain controversial. Recent findings call for a reappraisal of the established principles of early appendectomy on wide indications in order to preempt perforation as spontaneously resolving appendicitis is not uncommon. Most perforations have already occurred when the patient arrives to hospital. The mortality risk as a result of perforation must be weighed against the risk of appendectomy with a non-inflamed appendix. Avoiding appendectomy with a non-inflamed appendix is therefore more important than preventing perforation.