Open AccessCase-based review: conservative management of appendicitis – are we delaying the inevitable?
Author(s) -
Siân Davies,
Adam PeckhamCooper,
Ástrós Sverrisdóttir
Publication year - 2012
Publication title -
annals of the royal college of surgeons of england
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.39
H-Index - 63
eISSN - 1478-7083
pISSN - 0035-8843
DOI - 10.1308/003588412x13171221590296
Subject(s) - medicine , appendicitis , conservative management , perforation , presentation (obstetrics) , acute appendicitis , conservative treatment , intensive care medicine , general surgery , intervention (counseling) , treatment modality , surgery , psychiatry , materials science , punching , metallurgy
Acute appendicitis is a common surgical presentation for which surgical intervention, an appendicectomy, has remained a largely unchallenged primary treatment modality. Traditionally, it has been felt that the pathophysiological progressive nature of appendicitis ultimately leads to perforation. A number of recent studies, however, suggest that the process of appendiceal inflammation may follow a more remitting nature with evidence indicating spontaneous resolution. It is hypothesised that the treatment of uncomplicated appendicitis may therefore be amenable to conservative management with antibiotics. This article aims to highlight some of the issues and challenges relating to the conservative management of acute appendicitis and further demonstrates potential diagnostic and treatment difficulties involved in managing the more unfamiliar condition of recurrent appendicitis.