Nonoperative management of appendicitis in children.

PURPOSE OF REVIEW: The aim of this review is to summarize the recent literature investigating nonoperative management of uncomplicated and complicated appendicitis and highlight recent data establishing its safety and efficacy.

RECENT FINDINGS: Recent studies and clinical trials have demonstrated the efficacy of nonoperative treatment of both uncomplicated and complicated appendicitis, defined as perforated appendicitis with or without formed abscess or phlegmon. Nonoperative management of uncomplicated appendicitis has been reported to be effective in approximately 71-94% of cases. In complicated appendicitis, treatment with antibiotics alone or antibiotics with interval appendectomy has been shown to be a well tolerated and reasonable treatment alternative.

SUMMARY: Appendicitis is one of the most common surgical diagnoses in children. The standard of care for many years has been surgical appendectomy; however, it carries with it risks including bleeding, wound complications, injury to surrounding structures, and the potential need for reoperation. Nonoperative management of both uncomplicated and complicated appendicitis in children is well tolerated and efficacious in select populations.