Assessment of Non-Operative Management of Appendicitis in Adults

Appendicitis, traditionally managed with surgical intervention, has seen increasing interest in non-operative management (NOM) as a viable alternative for select adult patients. This approach, which often involves antibiotics and close monitoring, aims to avoid surgical risks and complications.

A prospective study was conducted on 150 adults diagnosed with uncomplicated appendicitis, confirmed by clinical evaluation and imaging. Patients were treated with a standardized antibiotic regimen (intravenous followed by oral antibiotics) and monitored for signs of resolution or progression. Outcomes such as symptom resolution, recurrence, and complications were assessed over a 12-month follow-up period. Statistical analyses were performed using Chi-square tests and logistic regression to identify predictors of success.

Of the 150 patients, 135 (90%) showed complete resolution of symptoms with NOM, while 15 (10%) required surgical intervention due to disease progression. Recurrence of appendicitis occurred in 25 patients (16.7%) within one year, with a mean recurrence time of 5.3 months. Complications were minimal, with five patients (3.3%) developing localized abscesses successfully managed with percutaneous drainage. No significant differences in outcomes were observed based on age, gender, or BMI. Patient satisfaction with NOM was high, with 85% expressing a preference for this approach over surgery.

Non-operative management is an effective and safe alternative for uncomplicated appendicitis in adults, with high success rates and minimal complications. However, the risk of recurrence remains a limitation.