Malonda, Franklin V. (2025) Acute appendicitis: is surgery still the best option? special consideration on pediatric and pregnant patients. Journal of Widya Medika Junior, 7 (4). pp. 223-234. ISSN 26561409
Preview |
Text (Acute appendicitis: is surgery still the best option? special consideration on pediatric and pregnant patients)
1-Acute_appendicitis_is_surgery_still_.pdf Download (323kB) | Preview |
Abstract
ute appendicitis, being one of the most prevalent causes of the acute abdomen in adult and pediatric patients, is marked by inflammation of the remnant of the vermiform appendix. When pregnancy and general surgery cases are combined, acute appendicitis is also a leading concern. For more than 10 decades, open surgery was the sole normative treatment for acute appendicitis. Nonoperative management (NOM) is a management strategy in which patients receive antimicrobials with the aim of averting surgery. Appendectomy is reserved for patients who do not respond to antimicrobials or who experience a relapse of appendicitis. However, the decision to conduct NOM has increased since the outbreak of COVID-19. NOM is suitable for patients with a first attack who have clinical signs of uncomplicated appendicitis without physical findings of diffuse peritonitis or imaging evidence of a large abscess, phlegmon, perforation, or tumor. The limited contraindications to NOM include patients who have a delayed response to antimicrobials, those with an appendicolith finding, and older patients because of a higher chance of latent malignancy. Treatment failure, either clinically or radiographically, as proven by bowel obstruction, sepsis, or persistent pain, pyrexia, or leukocytosis, necessitates prompt appendectomy. NOM may be an option for children who can describe their symptoms verbally, have a reliable and reproducible abdominal examination, and after shared decision-making among the overseeing pediatric surgeon and the parents or primary caregivers. The success rate of NOM in pediatric patients is about 67%–91%. The customary treatment of acute appendicitis in pregnancy remains appendectomy, with laparoscopic appendectomy being preferable to open appendectomy. The selection of strategy is based on clinical status and preferences, gestational age, and the surgeon’s level of experience. Under consideration of gestational age, NOM was more frequently chosen than appendectomy in the first and third trimesters. The overall success rate of NOM is 93%
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Acute appendicitis; Nonoperative management (NOM); Anti-microbials; Pediatric patient; Pregnant patient |
| Subjects: | Medicine |
| Divisions: | Journal Publication |
| Depositing User: | F.X. Hadi |
| Date Deposited: | 05 Jan 2026 08:26 |
| Last Modified: | 05 Jan 2026 08:26 |
| URI: | https://repositori.ukwms.ac.id/id/eprint/45228 |
Actions (login required)
 |
View Item |