Ultrasonographic Findings after Conservative Treatment of Acute Appendicitis and Open Appendicectomy

1995 ◽  
Vol 36 (2) ◽  
pp. 173-177 ◽  
Author(s):  
S. Eriksson ◽  
Å. Tisell ◽  
L. Granström
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Antibiotic Treatment ◽  
Randomized Study ◽  
Open Appendicectomy ◽  
Recurrent Appendicitis ◽  
Us Findings

In a randomized study we investigated the effects of antibiotics as the only treatment in acute appendicitis. Forty patients were examined, 19 after antibiotic treatment (one operated due to perforation) and 21 after surgery. All patients were examined prior to randomization, after 10 days and after 30 days. Of the positive ultrasonographic (US) findings, 18 (86%) of the 21 operated patients had histologically proven acute appendicitis. At the 10th day, 9 patients had a seroma under the scar, which had disappeared a month after surgery in all patients. In the 19 patients conservatively treated with antibiotics, the appendix could be visualized in 8 symptom-free cases on the 10th day. In 5 of the 8 patients the appendix was still visualized after 1 month. Three of these 5 had recurrent appendicitis within a year. It is concluded that US can be used not only in diagnosing acute appendicitis, but also in the evaluation of treatments such as antibiotics.

Can Acute Appendicitis be Treated by Antibiotics Alone?

2007 ◽  
Vol 73 (11) ◽  
pp. 1161-1165 ◽  
Author(s):  
Katherine Liu ◽  
Sadie Ahanchi ◽  
Mark Pisaneschi ◽  
Irene Lin ◽  
Robert Walter
Keyword(s):  
Length Of Stay ◽  
Acute Appendicitis ◽  
Antibiotic Treatment ◽  
Alternative Treatment ◽  
Complication Rate ◽  
Standard Of Care ◽  
Group I ◽  
Recurrent Appendicitis ◽  
Group Ii

Emergency appendectomy at presentation has been the standard of care for acute appendicitis. We examined the use of antibiotics as an alternative treatment. From September 2002 to August 2003, 170 consecutive patients diagnosed with acute appendicitis without abscess were reviewed retrospectively. Patients were divided into two groups: Group I (n = 151) underwent emergency appendectomy and Group II (n = 19) received antibiotics alone. The mode of treatment was at the attending surgeon's discretion. The overall complication rate was eight per cent for Group I and 10 per cent for Group II patients ( P = 0.22). Group II patients suffered no complications during antibiotic treatment, and any complications that did occur developed after subsequent appendectomy. One Group II patient had recurrent appendicitis (5%). The length of stay was 2.61 ± 0.21 days for Group I and 2.95 ± 0.38 days for Group II patients ( P = 0.57). Patients with acute appendicitis may be treated safely with antibiotics alone without emergency appendectomy.

scholarly journals TP10.2.2Adherence to the new Royal College of Surgeons (RCS) guidance pertaining to acute appendicitis management during COVID-19

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Rajab Khan ◽  
Sabina Shamsad ◽  
Umaimah Rahimi ◽  
Hamisha Salih ◽  
Humayun Razzaq ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Retrospective Study ◽  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Antibiotic Therapy ◽  
Surgical Management ◽  
Complicated Appendicitis ◽  
Global Pandemic ◽  
Imaging Results ◽  
Recurrent Appendicitis

Abstract Aims The mainstay of acute appendicitis treatment is a surgical approach. However, in the tumultuous COVID-19 era, the approach to acute appendicitis management has altered. We sought to assess the applicability of the new RCS COVID-19 guidance after resolution of the global pandemic. Methods A retrospective study was conducted on 244 patients presenting between 01/03/2020 and 17/07/2020. Three sources of data were sought: patients presenting to A&E with signs of appendicitis, operative logs for patients who underwent removal of their appendix and all CT/US scans where the clinician had queried appendicitis in the request. Results 139 patients were treated conservatively with antibiotics (57.0%). 35 (25.2%) represented within 6 months. Conservative treatment was successful in 92.1% of cases. 65 appendectomies were completed during that time. 45 cases presented acutely whereby the surgical management of acute appendicitis was the primary choice. The decision to operate was due to: 13 (20%) because the patient was 16 or younger. 4 cases presenting with signs of severe sepsis. 4 cases had a complicated appendicitis on their imaging results. 22 (33.8%) cases were completed without initial conservative management. 9 (3.7%) cases failed conservative treatment thus requiring surgical management. 11 (4.5%) cases represented within 6 months due to recurrent appendicitis despite successful antibiotic treatment. Therefore, the recurrence rate following conservative treatment was 7.9%. Conclusions There was mixed adherence to the new guidance. Surgical management remains the best approach towards acute appendicitis. However, excellent results can still be achieved with appropriately targeted antibiotic therapy.

scholarly journals Appendicectomy for Uncomplicated Simple Appendicitis: Is It Always Required?

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ibrahim Falih Noori Alsubsiee ◽  
Ahmed Falih Noori Alsubsiee
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Medical Treatment ◽  
Clinical Improvement ◽  
Antibiotic Treatment ◽  
Standard Treatment ◽  
Signs And Symptoms ◽  
Oral Antibiotics ◽  
Uncomplicated Appendicitis

Background. Although appendicectomy is still the classical and standard treatment for acute appendicitis, initial conservative antibiotic only treatment for simple uncomplicated cases has been proposed and tried as a feasible and effective approach. The objective of this study was to evaluate the efficacy and outcomes of antibiotics treatment for acute simple uncomplicated appendicitis. Methods. This is a prospective controlled nonrandomized study in which a total of 156 patients whose ages range from 16 to 54 years presenting with clinical diagnosis of acute uncomplicated appendicitis were assigned for conservative antibiotics treatment, which consists of ceftriaxone I gram twice daily and metronidazole infusions, 500 mg in 100 ml, 3 times daily for 48 to 72 hours to be converted on oral antibiotics after clinical improvement for 5 to 7 days. Patients who failed to initial conservative treatment and those who had recurring symptoms of appendicitis were presented for appendectomy. Results. Antibiotic treatment was successful and feasible in 138 (88.5%) patients. Progression of the signs and symptoms despite full medical treatment was observed in 11 (7%) patients during the same admission. Further 7 (4.5%) patients showed recurrence of the symptoms during follow-up period of 6–12 months after successful initial conservative treatment and also proceeded for appendicectomy. Conclusion. Nonoperative antibiotic treatment of acute simple appendicitis is safe, feasible, and effective for properly selected cases, thus avoiding unnecessary surgery with its possible complications.

scholarly journals The role of Ultrasound in Diagnosis of Acute Appendicitis: A Review Article

2021 ◽  
pp. 5-10
Author(s):  
Rania Mohammed Ahmed
Keyword(s):  
Acute Appendicitis ◽  
Patient Outcomes ◽  
Laboratory Data ◽  
Delay In Diagnosis ◽  
Technological Advances ◽  
Surgical Evaluation ◽  
Recurrent Appendicitis ◽  
Us Findings ◽  
Us Scan

Acute appendicitis (AA) is a frequent abdominal infection that affects 7% of people at some time in their lives. As a result, any delay in diagnosis might lead to complications such as perforation and abscesses in the incision. Ultrasound (U/S) plays an essential role in the diagnosis and management of acute appendicitis, which improves patient outcomes. Recent technological advances have brought profound changes to diagnostic ultrasound imaging. Acute appendicitis is a frequent abdominal condition that affects many people at their lives acute appendicitis is a difficult diagnosis based on clinical and laboratory data. Abnormal US findings during appendiceal scan indicate a greater chance of having recurrent appendicitis, US scan play an important role in the pre-surgical evaluation and planning of patients with appendicitis. In this review, different US techniques and their applications in diagnosis of appendicitis and early and accurate diagnosis are discussed.

scholarly journals 1185 Acute Paediatric Appendicitis(AA)-Decreasing The Negative Rate Of Appendicectomy

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Karagiannidis ◽  
O Toma ◽  
E Mallidis ◽  
F Youssef
Keyword(s):  
Data Collection ◽  
Conservative Treatment ◽  
Observational Study ◽  
Acute Appendicitis ◽  
First Trimester ◽  
Operative Management ◽  
Open Appendicectomy ◽  
Number Of Children ◽  
Negative Rate ◽  
Negative Appendicectomy

Abstract Aim The COVID -19 pandemic has forced changes in the management of Acute Appendicitis (AA), such as prioritising conservative management and avoiding laparoscopic procedures. This observational study aims to monitor and reduce the negative rate of paediatric appendicectomy and optimise the acute paediatric management following the newly introduced workflow. Method Retrospective patient data collection via electronic sources for all paediatric patients(0-16 years old) admitted with AA between March 23rd and October 31st 2020. Results During this period 74 patients were admitted with suspected AA. Conservative treatment was performed in 16 (22%) patients and operative management in 58 (78%), of which 15 (26%) had an open appendicectomy, while 43 (74%) underwent laparoscopic appendicectomy. The first trimester the negative appendicectomy rate was 25%, which dropped to 11% because of the newly introduced paediatric AA workflow and the more extensive use of US in the context of diagnosis of appendicitis.In the beginning of the study, the percentage of US scanning was 72% and was increased to 90% after the end of the 3rd period. Conclusions The introduction of the paediatric AA workflow and the more extensive use of US helped to decrease the percentage of negative rate of paediatric appendicecomy the number of children who underwent unnecessary operation.

scholarly journals Case-based review: conservative management of appendicitis – are we delaying the inevitable?

2012 ◽  
Vol 94 (4) ◽  
pp. 232-234 ◽  
Author(s):  
S Davies ◽  
A Peckham-Cooper ◽  
A Sverrisdottir
Keyword(s):  
Acute Appendicitis ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Primary Treatment ◽  
Spontaneous Resolution ◽  
Primary Treatment Modality ◽  
Uncomplicated Appendicitis ◽  
Recurrent Appendicitis ◽  
Appendiceal Inflammation ◽  
Surgical Presentation

Acute appendicitis is a common surgical presentation for which surgical intervention, an appendicectomy, has remained a largely unchallenged primary treatment modality. Traditionally, it has been felt that the pathophysiological progressive nature of appendicitis ultimately leads to perforation. A number of recent studies, however, suggest that the process of appendiceal inflammation may follow a more remitting nature with evidence indicating spontaneous resolution. It is hypothesised that the treatment of uncomplicated appendicitis may therefore be amenable to conservative management with antibiotics. This article aims to highlight some of the issues and challenges relating to the conservative management of acute appendicitis and further demonstrates potential diagnostic and treatment difficulties involved in managing the more unfamiliar condition of recurrent appendicitis.

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