Early Uncomplicated Appendicitis-Who Can We Treat Nonoperatively?

Title

Early Uncomplicated Appendicitis-Who Can We Treat Nonoperatively?

Creator

Horattas Mark C; HORATTAS ILEANA K; VASILIOU ELYA M

Publisher

American Surgeon

Date

2018
2018-02

Description

This study evaluated nonoperative treatment for mild appendicitis and reviewed selection criteria to be used in introducing this option into clinical practice. A retrospective review of 73 consecutive cases of appendicitis treated by a single surgeon from 2011 to 2013 was completed. Patients who were diagnosed with mild appendicitis meeting the criteria of an APPENDICITIS scoring algorithm proposed in this manuscript were considered for nonoperative management. An additional 17 patients with mild appendicitis were offered and successfully treated nonoperatively between 2014 and 2016 and reviewed. Of these original 73 patients, 37 had moderate to severe appendicitis and directly underwent appendectomy. The remaining patients were diagnosed with mild appendicitis and considered eligible for nonoperative management. Of these, 14 patients were offered nonoperative therapy. Thirteen responded successfully; one patient responded partially, but later opted for surgery. In 2014, this scoring system and preliminary results were shared with the other surgeons in our department. Nonoperative management was then selectively adopted by a few of the surgeons from 2014 to 2016 with another 17 patients (APPENDICITIS score of 0 or 1) being offered and successfully managed nonoperatively. Patients with mild or early appendicitis can be successfully managed nonoperatively. A proposed APPENDICITIS scoring system may provide a helpful mnemonic for successfully selecting patients for this option.

Subject

Adult; Female; Male; Aged; Young Adult; Prospective Studies; Patient Selection; Drug Administration Schedule; Appendectomy; Injections; Human; Middle Age; Adolescence; Retrospective Design; Intravenous; Administration; Oral; Treatment Outcomes; Severity of Illness Indices; Antibiotics – Therapeutic Use; Ampicillin – Therapeutic Use; Appendicitis – Diagnosis; Appendicitis – Drug Therapy; Appendicitis – Surgery; Enzyme Inhibitors – Therapeutic Use; Penicillins – Therapeutic Use

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

174–180

Issue

2

Volume

84

Citation

Horattas Mark C; HORATTAS ILEANA K; VASILIOU ELYA M, “Early Uncomplicated Appendicitis-Who Can We Treat Nonoperatively?,” NEOMED Bibliography Database, accessed May 11, 2021, https://neomed.omeka.net/items/show/5800.

Social Bookmarking