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A new analysis found that outpatient management of appendicitis with antibiotics is safe for selected patients, which may allow people to avoid hospitalization
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The presentation of acute appendicitis includes acute abdominal pain, nausea, vomiting, and fever. As the appendix becomes more swollen and inflamed, it begins to irritate the adjoining abdominal wall. This leads the pain to localize at the right lower quadrant. This classic migration of pain may not appear in children under three years.
Treatment is with antibiotics and drainage of the abscess; typically guided by ultrasound or CT, through the skin, via the rectum, or transvaginal routes. [3] Occasionally antibiotics may be used without surgery; if the abscess is at a very stage and small. [2] Until sensitivities are received, a broad spectrum antibiotic is generally required. [2]
There has been significant recent trial evidence that uncomplicated appendicitis can be treated with either antibiotics or appendicectomy, [4] [5] with 51% of those treated with antibiotics avoiding an appendectomy after 3 years. [6] After appendicectomy the main difference in treatment is the length of time the antibiotics are administered.
Erythromycin can be used in children, and tetracycline in adults. Some studies show, however, that erythromycin rapidly eliminates Campylobacter from the stool without affecting the duration of illness. Nevertheless, children with dysentery due to C. jejuni benefit from early treatment with erythromycin. Treatment with antibiotics, therefore ...
Appendicitis is one of the most common, and significant causes of severe abdominal pain, that comes on quickly. In 2015, about 11.6 million cases of appendicitis occurred, which resulted in about 50,100 deaths. [11] [12]
The sensitivity and specificity of MRI in diagnosing acute appendicitis are 94% and 96% respectively. [2] Laparoscopic surgery has also been used to diagnose the cause of IAIs when imaging is unhelpful. Besides, the laparoscopic surgery can also initiate treatment in the same setting. The accuracy is very high, in the range of 86 to 100%. [2]