Objectives To compare conservative treatment with index admission appendicectomy in children with acute uncomplicated appendicitis.
Conclusions Conservative treatment was less efficacious and was associated with a higher readmission rate. Index admission appendicectomy should in the present still be considered to be the treatment of choice for the management of uncomplicated appendicitis in children.
Question In children diagnosed with appendicitis, does delay in appendectomy within 24 hours of hospital presentation increase the risk of complicated appendicitis or adverse events?
Findings In this retrospective cohort study of 2429 patients from 23 children’s hospitals, delay of appendectomy within 24 hours of presentation was not associated with increased risk of complicated disease or postoperative complications.
Meaning These results support the premise that appendectomy can be performed as an urgent rather than emergency procedure.
Question Are antibiotics as initial treatment appropriate for uncomplicated acute appendicitis in pediatric patients?
Findings In this meta-analysis of 5 studies (including 404 patients), antibiotic treatment was safe and effective in 152 of 168 pediatric patients (90.5%), but the risk for treatment failure increased significantly in patients with appendicolith.
Meaning Antibiotic treatment can be used as primary treatment in pediatric patients presenting with acute uncomplicated appendicitis without appendicolith.