Non-surgical management of acute appendicitis: a systematic review

Abstract

Acute appendicitis (AA), one of the most common causes of lower abdominal pain, is the most common diagnosis given to young children admitted to the hospital with acute abdominal pain. According to statistics, the lifetime risk for AA was 9% in the USA, 8% in Europe, and 2% in Africa. Over the past 20 years, a rise in interest in the non-operative care of uncomplicated AA care has developed, most likely due to a more accurate analysis of postoperative complications and costs of surgical interventions, which are primarily connected with minimally invasive techniques, which are on the rise. This study aimed to evaluate the current literature on the non-surgical management of AA, thus, studies discussing the non-surgical management of AA between 2009 and 2022 were included. Initially, the non-operative treatment seemed possible to avoid appendectomy, reducing the need for surgery, surgical risks, and overall costs. Antibiotic therapy has a high success rate and is both feasible and effective; the risk of treatment failure is higher than the risk of appendectomy. Although the conservative treatment had a low overall failure rate, individuals who received upfront surgery had a greater complication risk.