RETRACTED ARTICLE: Conservative Management of Acute Appendicitis
The acute appendicitis is the most common abdominal emergency, and the primary treatment has been appendicectomy. Antibiotics are started preoperatively and continued postoperatively as needed.
This prospective study was carried out at Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, India to determine the role of antibiotics as the only treatment in acute appendicitis and the analgesic consumption needed. Total of 80 patients were included in the study with a duration of abdominal pain less than 72 h. Out of 80 patients, 40 patients received antibiotics intravenously for 2 days followed by oral treatment for 7 days, while another 40 patients considered as controls were randomized to surgery.
Patients managed conservatively were discharged within 3 days except for two—patients who required surgery after 12 and 24 h, respectively, because of peritonitis due to perforated appendicitis. Four patients were readmitted within 1 year as a result of recurrent appendicitis and had to undergo surgery when appendicitis was confirmed. The diagnostic accuracy within the operated group was 90%. Two patients had perforated appendicitis at operation.
Our conclusion is that antibiotic treatment in the patients with acute appendicitis is quite effective, and these patients may not need surgery. The patients managed conservatively with antibiotics alone experience less pain and require less analgesia but have high recurrent rate.
KeywordsAcute appendicitis Peritonitis Antibiotics Ultrasonography
- 1.McBurney C. Experiences with early operative interference in cases of disease of the vermiform appendix. N Y Med J 1889;50:1676–1684.Google Scholar
- 2.Coldrey E. Five years of conservative treatment of acute appendicitis. J Int Coll Surg 1959;32:255–261.Google Scholar
- 3.Anonymous. Combined traditional Chinese and western medicine in acute appendicitis. Chin Med J 1977;3:266–269.Google Scholar
- 5.Ambjommson E. Management of appendiceal abscess. Curr Surg 1984;41:4–9.Google Scholar
- 10.EACS. Acute appendicitis—Operative versus conservative management: EACS guidelines for endoscopic surgery. Heidelberg: Springer, 2006, pp 387–389.Google Scholar
- 16.Eriksson S, Granstrom L, Bark S. Laboratory tests in patients with suspected acute appendicitis. Acta Chir Scand 1989;155:11–20.Google Scholar
- 17.Granstrom L, Erikson S, Tisell A. Ultrasonography as a tool in the diagnosis of acute appendicitis: A prospective study. Surg Res Commun 1992;11:309–314.Google Scholar
- 21.Oeutsch AA, Shani N, Reiss R. Are some appendicectomies unnecessary? An analysis of 319 white appendices. J R Coll Surg Edinb 1983;28:35–40.Google Scholar
- 27.WeinJberg RW. Appendix ureteroplasty. Br J Urol 1976;48:234.Google Scholar