The Criteria for Treating Appendicitis Non-operatively

Abstract

There has been growing interest in the role of non-operative management of appendicitis. There have been multiple trials in adults, and there is a growing body of research in pediatric patients. This manuscript reviews the most recent trials and meta-analyses of non-operative management of acute, uncomplicated appendicitis in pediatric patients. Antibiotics alone are a safe treatment alternative for uncomplicated acute appendicitis without an appendicolith. There are no increased risks of complications or progression to complicated appendicitis with non-operative management with antibiotics alone. Approximately 20–25% of patients will fail non-operative management and will undergo an appendectomy within 1 year. Antibiotic therapy is a safe alternative treatment for acute, uncomplicated appendicitis in select pediatric patients based on history, clinical exam, imaging, and laboratory findings.