Conservative management of acute appendicitis.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Malik
Ajaz A
AA
Department of Surgery, Sher-i-Kashmir Institute of Medical Sciences, R/o Professors Colony, Naseem Bagh, Hazratbal, Srinagar, Kashmir, 19006, India. ajazamalik@yahoo.com
Bari
Shams-ul
SU
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D002939:Ciprofloxacin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D019233:Retreatment; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D002939:Ciprofloxacin