Appendicitis is the most common condition in children requiring emergency abdominal surgery with classical features including periumbilical pain that migrates to the right lower quadrant, anorexia, fever, and tenderness and guarding in the right iliac fossa. Acute appendicitis manifests in simple and complicated forms and appendectomy via open laparotomy or laparoscopy is the standard treatment for acute appendicitis. Several RCT’s are underway to study the efficacy and safety on non-operative treatment pathways.
During the past two decades the need for surgery in acute appendicitis among adult population has been questioned and more recently this issue has been addressed in children as well. The problems have stayed the same, how to detect the patients that need emergency operation and which patients can be treated non-operatively? Do antibiotics really play a role or is there room for symptomatic treatment?
Although acute appendicitis is one of the most common surgical conditions among children, not every patient will require an appendectomy. Non-operative treatment may be a reasonable option for simple appendicitis, which is difficult to reliably differentiate from complex appendicitis warranting operation. New ideas (algorithms, appendicitis scores, imaging) to improve diagnostics are welcomed as well as studies comparing different treatment modalities.
Appendicitis is the most common condition in children requiring emergency abdominal surgery with classical features including periumbilical pain that migrates to the right lower quadrant, anorexia, fever, and tenderness and guarding in the right iliac fossa. Acute appendicitis manifests in simple and complicated forms and appendectomy via open laparotomy or laparoscopy is the standard treatment for acute appendicitis. Several RCT’s are underway to study the efficacy and safety on non-operative treatment pathways.
During the past two decades the need for surgery in acute appendicitis among adult population has been questioned and more recently this issue has been addressed in children as well. The problems have stayed the same, how to detect the patients that need emergency operation and which patients can be treated non-operatively? Do antibiotics really play a role or is there room for symptomatic treatment?
Although acute appendicitis is one of the most common surgical conditions among children, not every patient will require an appendectomy. Non-operative treatment may be a reasonable option for simple appendicitis, which is difficult to reliably differentiate from complex appendicitis warranting operation. New ideas (algorithms, appendicitis scores, imaging) to improve diagnostics are welcomed as well as studies comparing different treatment modalities.
