Balancing a Surgical vs. Non-surgical Approach in Perforated Appendicitis

Appendicitis is the inflammation of the appendix, one of the common causes of acute abdomen that may indicate emergency abdominal surgical intervention. However, when complicated by perforation, phlegmon, and/or abscess formation, the standard and traditional treatment with the approach for a surgical intervention has been questioned regarding its risks and benefits. In this case presentation, our patient, who presented with perforated appendicitis complicated by phlegmon formation and ileus, was managed with a conservation approach through antibiotics and percutaneous drain placement. Although a conservative, non-surgical approach with interval appendectomy has become more of the popular approach in developed countries for complicated appendicitis due to increased morbidity in immediate appendectomy due to inflammation-associated adhesions, we wanted to present a case where a conservative approach can still lead to extended hospital stays due to complications.