Operative vs. Nonoperative Management for Appendicitis

In an NEJM Clinical Decisions article, experts debate over two management approaches for uncomplicated appendicitis.

A previously healthy 28-year-old man presents with acute appendicitis without appendicolith, abscess, or perforation. He wants to minimize time away from work and home. He has reservations about surgery but also wants to avoid recurrent appendicitis and future hospital visits. The clinician must decide which approach to recommend: appendectomy or initial treatment with antibiotics. Three surgeons provide their answers and perspectives.

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In a patient with acute appendicitis, antibiotics or surgery are both reasonable and evidence-based options. The patient’s priorities therefore should weigh heavily in the treatment decision. Even though medical management offers the possibility of returning to work sooner and long-term avoidance of sur…

Ann Cheung, M.D., M.B.A., M.S.Commentary Author

Disclosures

Nothing to disclose

Ann Cheung, M.D., M.B.A., M.S.Commentary Author

Disclosures

Nothing to disclose

Authors

Katerina Lin, M.D.

Theodore N. Pappas, M.D.

Dimitrios P. Moris, M.D., Ph.D.

David R. Flum, M.D., M.P.H.

Operative vs. Nonoperative Management for Appendicitis

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