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Conservative management of acute appendicitis.
1Department of Surgery, Sher-i-Kashmir Institute of Medical Sciences, R/o Professors Colony, Naseem Bagh, Hazratbal, Srinagar, Kashmir, 19006, India. ajazamalik@yahoo.com
Summary
Antibiotic therapy shows effectiveness for acute appendicitis, potentially avoiding surgery for some patients. However, conservative management may lead to recurrent appendicitis requiring later surgical intervention.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Infectious Disease Management
Background:
- Acute appendicitis is a leading cause of abdominal emergencies.
- Appendicectomy remains the standard surgical treatment.
- Preoperative and postoperative antibiotics are commonly administered.
Purpose of the Study:
- To evaluate antibiotics as a sole treatment for acute appendicitis.
- To assess analgesic requirements in non-operative management.
- To compare conservative versus surgical approaches.
Main Methods:
- Prospective study of 80 patients with abdominal pain < 72 hours.
- 40 patients received 9-day antibiotic therapy (IV then oral).
- 40 control patients underwent immediate surgery.
Main Results:
- Conservative group discharged within 3 days, barring two cases of peritonitis.
- Two patients developed peritonitis due to perforated appendicitis.
- Four patients experienced recurrent appendicitis within a year, necessitating surgery.
Conclusions:
- Antibiotic treatment is effective for acute appendicitis, offering a non-surgical option.
- Conservative management reduces pain and analgesic needs.
- A significant rate of recurrent appendicitis necessitates careful follow-up.
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