Abstract
Acute appendicitis is the most common reason for abdominal surgery in children. Though appendectomy considered the gold standard there are a lot of complications related to it. Conservative management of acute appendicitis is not new to medical science. In pandemic like COVID-19 when all the health systems were about to shut-down because of lack of manpower and resources, we started a trial of non-operative management. The main aim of this study is to find out the management of acute appendicitis during COVID-19. This was a descriptive cross-sectional study conducted in a tertiary care centre. Data collection was done from the record section which included the patients diagnosed with acute appendicitis from February 2020 to July 2020 after obtaining ethical clearance from Institutional Review Committee. Cases of appendicular lump, appendicular abscess, appendicular perforations have been excluded. Data was collected and entry was done in Statistical Package for the Social Science software version 20, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. The conservative management of acute appendicitis was done in 44 cases (55.7%) while 35 cases (44.3%) had to undergo appendectomy. COVID-19 can complicate the perioperative course as a result of direct lung injury and multiple organ dysfunctions and can also bring serious threats to the safety of medical staffs involved in managing the acute appendicitis case operatively, so conservative management can be considered as an alternative way of management of acute appendicitis in the pandemic outbreak.
Highlights
Acute appendicitis is the most common reason for abdominal surgery in children
The conservative management of acute appendicitis was done in 44 cases (55.7%) while 35 cases (44.3%) had to undergo appendectomy
COVID-19 can complicate the perioperative course as a result of direct lung injury and multiple organ dysfunctions and can bring serious threats to the safety of medical staffs involved in managing the acute appendicitis case operatively, so conservative management can be considered as an alternative way of management of acute appendicitis in the pandemic outbreak
Summary
Acute appendicitis is the most common reason for abdominal surgery in children. Though appendectomy considered the gold standard there are a lot of complications related to it. Acute appendicitis (AA) is the leading reason for abdominal surgery in children.[1,2,3] Based upon assumption that AA is irreversible progressive disease, leading to perforation of appendix with subsequent peritonitis, appendectomy is considered as gold standard.[4] curative, appendectomy is invasive procedure requiring general anesthesia with associated perioperative risks and postoperative complications in about 10% within 30 postoperative days.[5,6] theatre time, staff time and surgical resources.[1,7,8] patients with the COVID-19 have substantially higher operative risks due to the compromisation of lung function and the cytokine storms that result in systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction.[9].
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