Clinical Outcomes of Non-Operative Treatment of Suspected Uncomplicated Appendicitis in Children

Abstract

Aim
 Non-operative treatment approach is another method used in the treatment of uncomplicated appendicitis, in which the infection in the appendix is suppressed and treated with antibiotics. Our study aims to investigate the clinical outcomes and the risk factors for recurrence in our pediatric patients with suspected uncomplicated appendicitis, who underwent non-operative treatment.
 Methods
 The medical data of the patients who underwent non-operative treatment with the diagnosis of suspected uncomplicated appendicitis between January 2016 and January 2021 in a tertiary pediatric surgery center were analyzed. Demographic data, treatment process, and clinical results of the patients were recorded. Statistical evaluation was made by comparing the two groups with and without recurrence after non-operative treatment.
 Results
 The median age of 41 patients whose data were evaluated was 13 (6-17) years. Eight patients (19.5%) had appendicolith. The median duration of IV antibiotic treatment was 4 (3-7) days, and the patients' abdominal tenderness disappeared in a median of 2 (1-4) days. Recurrence developed in 8 (19.5%) patients after a median of 7 (1-14) months after non-operative treatment. It was found that the time to the disappearance of abdominal tenderness was statistically longer in the group that developed recurrence than that in the group that did not (p=0.01).
 Conclusion
 Our study revealed that appendicolith was not a risk factor for the development of recurrence. The time to the disappearance of abdominal tenderness may be useful for detecting patients at a higher risk of recurrence.