Hyoung-Chul Park1, Min Jeong Kim1, Bong Hwa Lee2. 1. Department of Surgery, Hallym University College of Medicine, 896 Pyeongchon-Dong, Dong An-Gu, Anyang 431-070, Republic of Korea. 2. Department of Surgery, Hallym University College of Medicine, 896 Pyeongchon-Dong, Dong An-Gu, Anyang 431-070, Republic of Korea. Electronic address: greatpa1@daum.net.
Abstract
PURPOSE: Although many patients receive antibiotic therapy for uncomplicated appendicitis, the relatively high treatment failure and recurrence rates are problematic. We assumed that patients with appendicitis and appendiceal diameters ≤ 10 mm, have better outcomes. The purpose of this prospective non-randomized study was to assess the outcomes of antibiotic therapy in patients with uncomplicated appendicitis and appendiceal diameters ≤ 10 mm. METHODS: Over 2 years, we enrolled 119 patients who initially received antibiotic therapy. The failure of antibiotic therapy was defined as the need for appendectomy and true appendicitis. Peritonitis was defined as either complicated appendicitis or intra-abdominal abscess postoperatively. We evaluated the rates of treatment failure, peritonitis, and recurrence. RESULTS: Nine patients (7.6%) failed to respond to initial antibiotic therapy, and 6 had true appendicitis after subsequent surgery. Two patients had complicated appendicitis (peritonitis), but no patient displayed intra-abdominal abscess postoperatively. During a median follow-up period months of 14 months, 14 patients (12.7%) experienced recurrence. CONCLUSIONS: Antibiotic therapy without surgery may be a safe treatment for uncomplicated appendicitis in select patients with appendiceal diameters ≤ 10 mm.
PURPOSE: Although many patients receive antibiotic therapy for uncomplicated appendicitis, the relatively high treatment failure and recurrence rates are problematic. We assumed that patients with appendicitis and appendiceal diameters ≤ 10 mm, have better outcomes. The purpose of this prospective non-randomized study was to assess the outcomes of antibiotic therapy in patients with uncomplicated appendicitis and appendiceal diameters ≤ 10 mm. METHODS: Over 2 years, we enrolled 119 patients who initially received antibiotic therapy. The failure of antibiotic therapy was defined as the need for appendectomy and true appendicitis. Peritonitis was defined as either complicated appendicitis or intra-abdominal abscess postoperatively. We evaluated the rates of treatment failure, peritonitis, and recurrence. RESULTS: Nine patients (7.6%) failed to respond to initial antibiotic therapy, and 6 had true appendicitis after subsequent surgery. Two patients had complicated appendicitis (peritonitis), but no patient displayed intra-abdominal abscess postoperatively. During a median follow-up period months of 14 months, 14 patients (12.7%) experienced recurrence. CONCLUSIONS: Antibiotic therapy without surgery may be a safe treatment for uncomplicated appendicitis in select patients with appendiceal diameters ≤ 10 mm.
Authors: Wonju Hong; Min Jeong Kim; Sang Min Lee; Hong Il Ha; Hyoung Chul Park; Seung Gu Yeo Journal: Korean J Radiol Date: 2020-08-11 Impact factor: 3.500