Conservative treatment in acute appendicitis

JNMA J Nepal Med Assoc. Oct-Dec 2010;50(180):295-9.

Abstract

Introduction: Acute appendicitis is one of the commonest surgical problems and appendectomy is one of the most commonly done operations in the emergency world wide. Though there have been occasional reports with conservative treatment in acute appendicitis, it is not being practiced as a routine.

Methods: All patients between ten to sixty years of age admitted at BPKIHS with the diagnosis of acute appendicitis over a period of one year were enrolled in the study. After taking informed consent the patients were managed conservatively. Those who did not respond to antibiotics within 24 hours were operated. Total hospital stay and complications were recorded and they were followed up at first week, sixth week and sixth month. The success rate, conversion rate, recurrence rate and morbidity and mortality pattern were assessed as the final outcome of conservative treatment of acute appendicitis.

Results: A total of 96 patients (48 males and 48 females) underwent conservative treatment. The conservative treatment was successful in 79 (82.3%) cases and failed in 11 (11.4%) cases, which included: conversion to appendectomy during conservative treatment period 4 (4.2%) cases, recurrence 7 (7.3%) cases. There was no mortality in this study.

Conclusion: Acute appendicitis can be treated successfully with conservative (antibiotics) treatment with a short hospital stay. Though there is a risk of recurrence in some cases, all the complications after appendectomy can be eliminated with the conservative treatment.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Anti-Infective Agents / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Appendicitis / therapy*
  • Ceftriaxone / therapeutic use*
  • Child
  • Cross-Sectional Studies
  • Diclofenac / therapeutic use*
  • Female
  • Fluid Therapy / methods*
  • Humans
  • Male
  • Metronidazole / therapeutic use*
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome

Substances

  • Anti-Infective Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Metronidazole
  • Diclofenac
  • Ceftriaxone