Fast Five Quiz: Appendicitis Diagnosis and Treatment

Richard H. Sinert, DO


March 13, 2019

Appendectomy remains the only curative treatment of appendicitis, but management of patients with an appendiceal mass can usually be divided into the following three treatment categories:

  • Patients with a phlegmon or a small abscess: After IV antibiotic therapy, interval appendectomy can be performed 4-6 weeks later.

  • Patients with a larger, well-defined abscess: After percutaneous drainage with IV antibiotics is performed, the patient can be discharged with the catheter in place. Interval appendectomy can be performed after the fistula is closed.

  • Patients with a multicompartmental abscess: These patients require early surgical drainage.

Although many controversies surround the nonoperative management of acute appendicitis, antibiotics have an important role in the treatment of patients with this condition. A randomized trial with 5 years of follow-up data found that antibiotics may be a feasible alternative to surgery in patients with uncomplicated acute appendicitis. Antibiotics considered for patients with appendicitis must offer full aerobic and anaerobic coverage. The duration of the administration is closely related to the stage of appendicitis at the time of the diagnosis, considering either intraoperative findings or postoperative evolution.

Read more on the treatment of appendicitis.


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