Acute appendicitis, is it possible to cure without surgery ?

الملخص EN

The aim of this trial is to evaluate the protocol of treating selected cases of adult acute appendicitis by non-surgical measures.

Appendicitis is the most common cause of acute abdomen, for many years the adapted treatment of this disease is by immediate surgery to avoid the serious morbidity and mortality, now a small study suggest that using non-surgical treatment using antibiotic may give same result in curing patients and avoidance of surgery may eliminate the possible morbidity and even mortality in selected patients.

This is a prospective non-randomized study of 84 adult patients with acute appendicitis, clinically diagnosed, from both genders were treated in Basra General Hospital from 2005-2009, by intravenous anti biotic, nothing by mouth and clinical monitoring.

From the 35 female patients, only six cases did not show clinical improvement, surgery revealed perforated appendicitis in two, pathology other than appendicitis in four (salpingitis, ectopic gestation, ruptured graafian follicle, twisted ovarian cyst respectively).

From the 49 male patients, five cases did not show clinical response, operations showed gangrenous and perforated appendicitis in two, other pathology in three (pelvic lymphadenitis, gastroenteritis and urinary tract infection).

In conclusion, the non operative regime for treatment of early acute appendicitis is successful, it can be used to treat certain types of patients including high risk patients and when surgical facilities are not available.