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[The pediatric surgeon and acute appendicitis].
M Ait Ali Slimane1, P Montupet
1Clinique chirurgicale de Boulogne-Billancourt, 105, avenue Victor-Hugo, 92100 Boulogne-Billancourt, France. malikaaitali@yahoo.fr
Journal De Chirurgie
|October 23, 2009
Summary
Acute appendicitis management in children is evolving. Uncomplicated cases may only need antibiotics, while complicated cases benefit from initial antibiotics and delayed surgery, with laparoscopic approaches still debated.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Context:
- Recent shifts in managing acute appendicitis in pediatric patients.
- Apparent success of non-operative management for simple appendicitis.
Purpose:
- To review current strategies for pediatric acute appendicitis.
- To evaluate the role of antibiotics and surgical interventions.
Summary:
- Uncomplicated acute appendicitis can be managed non-operatively with antibiotics, potentially avoiding appendectomy.
- Complicated appendicitis (perforation, abscess) is treated with antibiotics and possibly drainage, followed by delayed appendectomy.
- The utility of laparoscopic appendectomy for uncomplicated cases is debated, showing minimal advantages over open surgery.
Impact:
- Highlights the evolving paradigm in pediatric appendicitis care.
- Suggests a more conservative approach for uncomplicated cases.
- Emphasizes the importance of surgical expertise and service organization in appendicitis management.
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