Shared decision-making in acute uncomplicated appendicitis: A case-based approach
Haley D Kittle1, Loren Berman2
1Nemours Anesthesia and Surgical Outcomes Center, Nemours Children's Health, Wilmington, DE, USA.
Seminars in Pediatric Surgery
|August 7, 2026
Summary
Nonoperative management (NOM) for acute uncomplicated appendicitis is a viable alternative to surgery. Shared decision-making (SDM) is crucial for involving pediatric patients and families in choosing the best treatment path.
Area of Science:
- Pediatric Surgery
- Clinical Decision-Making
Background:
- Acute uncomplicated appendicitis is commonly treated with appendectomy.
- Nonoperative management (NOM) is an emerging alternative for select cases.
- Increased public awareness necessitates clear treatment guidelines.
Purpose of the Study:
- To evaluate the role of shared decision-making (SDM) in pediatric appendicitis treatment.
- To provide a framework for offering nonoperative management (NOM) as an alternative.
- To highlight the importance of patient and family involvement in treatment decisions.
Main Methods:
- Review of evidence-based criteria for nonoperative management.
- Application of shared decision-making (SDM) principles.
- Case-based examples illustrating SDM in pediatric appendicitis.
Main Results:
- Nonoperative management (NOM) is a safe and effective option for acute uncomplicated appendicitis meeting specific criteria.
- Shared decision-making (SDM) effectively incorporates patient and family values.
- Pediatric patients and their families can be successfully engaged in treatment choices.
Conclusions:
- Nonoperative management (NOM) should be offered as an alternative to appendectomy for acute uncomplicated appendicitis.
- Shared decision-making (SDM) is essential for pediatric cases, ensuring patient and family-centered care.
- Implementing SDM facilitates informed choices regarding appendicitis treatment.
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