Elzoghby, M., Ibrahim, M., Mobarak, A., Gobran, T., Ahmed, K. (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
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
Elzoghby, M., Ibrahim, M., Mobarak, A., Gobran, T., Ahmed, K. (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
Elzoghby, M., Ibrahim, M., Mobarak, A., Gobran, T., Ahmed, K. 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
Evaluation of Non-Operative Management of Pediatric Acute Non-Complicated Appendicitis
1Department of Pediatric Surgery, Faculty of Medicine, Suez Canal University, Egypt
2Department of Pediatric Surgery, Faculty of Medicine, Zagazig University, Egypt
Abstract
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.
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