Nonoperative Management of Appendicitis Is a Viable Option

Several large-scale studies have compared surgical and medical strategies for management of acute appendicitis (NEJM JW Emerg Med Nov 2018). Now, researchers have tapped an insurance company database to compare outcomes of the two strategies.

Of about 60,000 patients with uncomplicated appendicitis, 4.5% were initially managed with antibiotics alone (no appendectomy). The authors assessed various outcomes, including readmissions, abscess development, number of follow-up visits, and total costs of care. The vast majority of patients in both groups did well, although subtle differences favored the surgical approach.