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Acute Appendicitis in Childhood and Adulthood

Patrick Téoule1, Jan de Laffolie, Udo Rolle

  • 1Department of Surgery, Universitäts -medizin Mannheim, Medical Faculty Mannheim, Heidelberg UniversityDepartment of General Pediatrics and Neonatology, Pediatric Gastroenterology, University of Giessen, GermanyDepartment of Pediatric Surgery, University Hospital Frankfurt, Goethe-University Frankfurt am Main, Frankfurt, Germany.

Deutsches Arzteblatt International
|February 3, 2021
PubMed

Insights

Acute appendicitis, a common cause of acute abdomen, is best treated with appendectomy. While conservative management is increasing, current evidence does not support replacing surgery as the standard therapy for appendicitis.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Medical Diagnostics

Background:

  • Acute appendicitis is the most frequent cause of acute abdomen.
  • It is a key differential diagnosis for undiagnosed abdominal pain.

Purpose of the Study:

  • To review current diagnostic and treatment strategies for acute appendicitis.
  • To evaluate the role of conservative versus surgical management.

Main Methods:

  • Selective literature search of PubMed and Cochrane Library.
  • Review of publications on appendicitis diagnosis and treatment.

Main Results:

  • Diagnosis involves medical history, physical exam, lab tests, and imaging (ultrasound, CT, MRI).
  • Appendectomy is the primary treatment; conservative management is an option for uncomplicated and complicated appendicitis in select cases.
  • Approximately 37% of adults treated conservatively for appendicitis may require surgery within a year.

Conclusions:

  • Conservative treatment for appendicitis is becoming more common.
  • Current evidence does not support a shift from surgical treatment to conservative management as the standard of care.
Abstract

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