CONSERVATIVE VERSUS OPERATIVE TREATMENT OF CLINICALLY SUSPECTED UNCOMPLICATED ACUTE APPENDICITIS

Volume 14 , Issue 2 , June 2024 , Pages 231-237

Authors

Rzgar Muhedin Ahmad 1

1 College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

DOI logo 10.17656/jsmc.10470

Keywords

Abstract

Background
Acute appendicitis is one of the most frequent causes of an acute abdomen. There is an important controversy
concerning the management of acute, uncomplicated appendicitis by surgery and nonsurgical means.
Objectives
To evaluate the results of conservative treatment in cases of clinically uncomplicated acute appendicitis,
starting with antibiotics as an initial step.
Patients and Methods
A 2-year prospective study, from February 2021 to January 31, 2023, was conducted in Sulaimani Teaching
Hospital in Sulaimani Governorate. Patients who presented with acute appendicitis within 72 hours of the onset
of the symptoms and had an Alvarado score of ≥5 or more were included. The patients received therapeutic
doses of broad-spectrum antibiotics in addition to symptomatic treatment. There was a follow-up period of
six months.
Results
Of the 54 patients enrolled in the study, the mean age was 34.4 years; 32 (60%) were female and 22 (40%) were
male. Thirteen patients (24.4%) had unsuccessful conservative treatment, compared to 41 (75.6%) who were
successful. There was no recorded mortality in this research. The complications that developed in patients
who did not react well to conservative treatment Eight patients with acute suppurative appendicitis—one with
a perforated appendix, two with an appendicular abscess, and two with an appendicular mass—were among
the surgical patients.
Conclusion
The majority of cases of uncomplicated acute appendicitis presented with a first attack can be successfully
treated conservatively. On the other hand, conservative treatment needs good communication, vigilant
observation, and frequent examination to detect failure that requires rapid surgical intervention.

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