Nonoperative approach in children uncomplicated appendicitis at tertiary care centre
Journal Title: Medpulse International Journal of Surgery - Year 2018, Vol 7, Issue 2
Abstract
Aim: To evaluate the effectiveness of non-operative approach in children with uncomplicated acute appendicitis using antibiotic as a first treatment plan and to assess the treatment outcome. Material and Metho d: 60 children with a history of pain in right iliac fossa and diagnosed as the first attack of appendicitis were included. Ultrasound of abdomen confirm the clinical diagnosis. After diagnosis, all patients were given intravenous antibiotics during the period of hospital stay. Patients whose signs and symptoms had improved discharged home after 72 hrs of observation. On discharge, we shift to oral antibiotics for two weeks. Results: 60 children of uncomplicated acute appendicitis were included and managed nonoperatively. 36 (60%) were male and 24 (40%) patients were female. Mean age was 8.2±3.1 years and range between 2 to 18 years. Mean duration of symptoms was 2±2.4 days. In the 60 patients who were managed non-operatively for uncomplicated acute appendicitis, non-operative treatment was successful in 43 (71.7%) patients with no treatment failure or recurrence in the follow-up period of 6 months. However, in the remaining 17 (28.3%) patients, non-operative treatment was failed. Treatment failure during initial admission was seen in 12 patients (20%) whereas recurrence was seen in 5 patients (8.3%) cases who were successfully managed during primary admission. Conclusion: Uncomplicated acute appendicitis can be treated successfully by non-operative approach thereby avoiding ppendectomy and its associated morbidity and mortality. However, non-operative approach requires monitoring and repeated re-evaluation
Authors and Affiliations
Nisty Mallikarjun V, Shinde Nandkishor D, Moinuddin Mohammed, Devani Ravindra
Keywords
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