Background: Acute appendicitis is the most common abdominal surgical emergency in the pediatric age group. The conventional management was to perform appendectomy at the time of diagnosis. Although appendectomy is a relatively safe procedure it requires anesthesia and is associated with risks related to surgery. The non-operative management approach was adopted to avoid potential risks and to give patients and parents alternative safe options rather than surgery. Aim:To evaluate non-operative management safety and feasibility for treatment of pediatric acute non-complicated appendicitis. Patients and Methods: Prospective observational study was conducted in Suez Canal University Hospital on patients presenting with acute noncomplicated appendicitis confirmed by radiological modality. The study included 124 children with ages ranging from 4 to 12 years. Non-operative management was initiated for 48 hours after applying strict inclusion criteria with continuous assessment and patients who failed to respond proceeded to appendectomy. Follow-up of patients was done for 1 year after presentation. Results: Initial response to non-operative treatment had a statistically significant success rate of (88.8%) of cases having complete resolution (p-value = 0.001). After one year of follow up about (79%) of children had complete resolution of symptoms with no appendectomies. The recurrence rate was about (29%) of cases. Recurrence of symptoms and failure of treatment was correlated to higher degrees of fever, Abdominal rigidity, higher Alvarado scores and increased appendiceal diameter. Conclusion: Non-operative treatment in cases of pediatric non-complicated acute appendicitis is safe and feasible option of management but with strict selection criteria of patients to avoid complications.
Elzoghby, M. M., Ibrahim, M. S., Mobarak, A. M., Gobran, T. A., & Ahmed, K. E. (2023). Evaluation of Non-Operative Management of Pediatric Acute Non-Complicated Appendicitis. Suez Canal University Medical Journal, 26(7), 28-36. doi: 10.21608/scumj.2023.309502
MLA
Mohamed M. Elzoghby; Mohamed S. Ibrahim; Ahmed M. Mobarak; Tarek A. Gobran; Karam E. Ahmed. "Evaluation of Non-Operative Management of Pediatric Acute Non-Complicated Appendicitis", Suez Canal University Medical Journal, 26, 7, 2023, 28-36. doi: 10.21608/scumj.2023.309502
HARVARD
Elzoghby, M. M., Ibrahim, M. S., Mobarak, A. M., Gobran, T. A., Ahmed, K. E. (2023). 'Evaluation of Non-Operative Management of Pediatric Acute Non-Complicated Appendicitis', Suez Canal University Medical Journal, 26(7), pp. 28-36. doi: 10.21608/scumj.2023.309502
VANCOUVER
Elzoghby, M. M., Ibrahim, M. S., Mobarak, A. M., Gobran, T. A., Ahmed, K. E. Evaluation of Non-Operative Management of Pediatric Acute Non-Complicated Appendicitis. Suez Canal University Medical Journal, 2023; 26(7): 28-36. doi: 10.21608/scumj.2023.309502
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