Conservative Management of Acute Appendicitis in a Tertiary Care Center

Abstract

Background and Aim: Appendectomy is the most favored treatment of appendicitis in most of the cases. Considered safeand routine surgery few patients develop complications of surgery like recurrent pain, obstruction, wound complicationsand rarely fistula and death. Present study was done with an aim to study the outcome of conservative treatment in acuteappendicitis using antibiotic therapy.Material and Methods: The present study was a prospective study conducted at the medical institute and associatedhospital for a period of 2 years. All the patients attending our emergency department with pain in the lower abdomenwere assessed clinically for signs of acute appendicitis. Injection ceftriaxone and injection metronidazole was given for48-72 hours. Patients who responded for i.v. antibiotics were switched to tablet ciprofloxacin and tablet metronidazole for7 days and followed for 6 months.Results: In this present study, 200 patients were included. 168 patients had migratory abdominal pain in the presentstudy. Anorexia was seen in 180 patients and absent in 20 patients. 174 patients had nausea and vomiting. Tenderness inthe right inguinal fossa was seen in all the patients. Rebound tenderness was seen in 68 patients and absent in 132 patients.Conclusion: The overall success rate of conservative treatment according to the present study was 82%. However, therewere 12% failures and 6% recurrences in the present study. The success rate of conservative treatment in patients withMAS 4-6 is more than the patients with MAS 7-9 according to the present study.