Non-operative management of acute appendicitis in children: single center, cohort study

BACKGROUND: Appendicitis is a common cause of abdominal pain in children and appendectomy is regarded as the first-line treatment. The purpose of this study was to examine the efficacy of non-operative treatment in complicated and uncomplicated cases of acute appendicitis in children.METHODS: In this study, children who were hospitalized in the Pediatric Surgery Clinic of the University General Hospital in Heraklion Crete from 2017 till 2019. Out of 145 patients, 31 were treated non-operatively and 13 out of 31 relapsed and underwent an appendectomy (41.9%).RESULTS: In total, 5 patients out of the aforementioned 31 had complicated appendicitis and 3 of them required surgical treatment. Two pa-tients treated conservatively were referred to our hospital with symptoms indicative of acute appendicitis, however surgical intervention was not required. Out of the patients who underwent an appendectomy, one was admitted again due to Intestinal adhesions with obstruction, one was referred to the hospital because of post-surgical bowel disorders, and one because of trauma purulence.CONCLUSIONS: It can be inferred that a protocol of conservative management of acute appendicitis should be implemented, according to which patients with uncomplicated appendicitis are treated non-operatively and in case they relapse, undergo surgical treatment.