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Appendectomy for acute appendicitis in emergency
is universally accepted and effective procedure. I
Only in United States more than 300,000
appendicectomy are performed annually.
Statistically, the life-time risk to have acute
appendicitis is 8.6% in men and 6.7% in women but
the risk for emergency appendectomy is 12% and
23%, respectively. Pathologically, acute appendicitis
progresses invariably from mild inflammation to
gangrene and perforation and as a treatment the
emergency appendectomy is always required. 2 The
non-operative management of uncomplicated acute
salpingitis, cholecystitis and diverticulitis has been
well established but the non-operative management
of acute appendicitis remains controversial. 3 Some
centers or surgeons use preoperative antibiotic to
treat acute appendicitis in selected cases for
delaying an appendectomy, particularly during
twilight hours. In these cases the incidence of
perforation, other complications and hospital stay
especially in children operated within 6 h is
equivalent to those who underwent emergency
appendicectomy between 6 and 18 h after
admission. Literature review conclude that although
antibiotics may be used as the primary treatment in
acute appendicitis in selected cases, but this is
treatment option is less likely to supersede
2,4
appendectomy as a definitive treatment modality.
There are only one Cochrane analysis, five meta-
analysis and some review article were found after
extensive literature search about non-operative
treatment of acute appendicitis. All these studies
concludes that non operative treatment may reduce
Ishtiaq Ahmed. (2015) Non Surgical Management of Acute Appendicitis, Journal of Islamic International Medical College, Volume-10, Issue-1.
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