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Title : Conservative Management of Early Uncomplicated Appendicitis in Children in a Tertiary Care Hospital

Published by -Jalalabad Medical Journal PDF Page : 51-56

The gold standard treatment for acute appendicitis is appendectomy. However, growing evidence indicates that patients with acute uncomplicated appendicitis can be treated safely with antibiotics. This prospective interventional study was conducted in the department of Paediatric Surgery, Jalalabad Ragib-Rabeya Medical College Hospital, Sylhet during the period of one and half years from April 2016 to September 2017 to evaluate the efficacy and outcomes of the conservative management of acute uncomplicated appendicitis in children with an antibiotic first plan. A total of 54 children from ≥3-14 years of age, with clinical and radiological features of acute appendicitis presenting within 72 hours of the beginning of abdominal pain with modified Alvarado score ≥6 were included in the study. All patients received a therapeutic dose of broad-spectrum antibiotics and symptomatic treatment. The follow-up period was 1 year. Among the study population, 30 (55.6%) patients were male and 24 (44.4%) were female with mean age 11.4 years. Conservative treatment was successful in 42 (77.8%) patients and failed in 12 (22.2%) patients. Overall, complications that resulted from non-operative treatment were low and only two cases complication (Appendicular lump and gangrenous appendix; one patient each) occurred throughout the entire study group. So, it may be concluded from the study that cconservative management of early uncomplicated acute appendicitis with antibiotics treatment is a safe option in children.

Keywards: Acute appendicitis, Antibiotics, Conservative treatment, Uncomplicated acute appendicitis.