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Non-operative management of uncomplicated appendicitis in children: Where do we stand?
Elizabeth A Barmash1, Peter C Minneci2, Kyle J Van Arendonk1
1Center for Surgical Outcomes Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, OH, USA.
Abstract:
Non-operative management (NOM) for children with uncomplicated appendicitis has emerged as a safe alternative to appendectomy. Despite increasing adoption, uncertainty persists regarding optimal patient selection, outcome interpretation, and real-world implementation. Variability in trial design, outcome definitions, and clinician perspectives have further contributed to ongoing debate surrounding the role of NOM in contemporary pediatric care. This review synthesizes current evidence evaluating the safety, effectiveness, and patient-centered outcomes of NOM for uncomplicated appendicitis in children, with an emphasis on practical guidance for clinicians navigating management decisions through shared decision-making with patients and their families.
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