More studies will be needed to turn one gold standard of treatment upside down:
Untreated appendicitis can have serious consequences. But surgery may not be the only option for children with appendicitis.
A research team tested whether appendicitis in children could be treated effectively with antibiotics, avoiding the serious procedure and recovery period associated with surgery.
Appendicitis occurs when the appendix, a very small organ near the intestines, becomes inflamed or infected, swollen and painful.
The researchers found that appendicitis was successfully treated with antibiotics in almost all of the children who were treated with them. This treatment meant kids could return to school sooner and felt better than the children whose appendicitis was treated with surgery.
The results showed that 93 percent of the children treated without surgery had a successful recovery that did not require an appendectomy. After 30 days, the success rate in this group was 90 percent.
The no-surgery group had an average of three days of recovery, compared to 17 days for the group of children who had surgery. They returned to school two days earlier than the surgery group. Parents and children in the no-surgery group felt better during the recovery period than the families in the surgery group.
“[F]or families who are averse to surgery, initial non-operative therapy may be the least stressful and most appealing choice because it may eliminate the need for an operation and its inherent risks while expediting a quicker return to activities,” the authors wrote.
“Non-operative management of uncomplicated acute appendicitis in children is feasible with a high 30-day success rate and short-term benefits including a quicker recovery and improved quality of life scores,” they concluded.
Removing a diseased appendix surgically should have close to a 100% success rate. Surely there are potential side effects of having an operation — both in the short and the long terms — including infections, fibrous adhesions, and death. And going to the operating room and recovering in a hospital is expensive. But the 90% success rate after 30 days is not 100%. Unless we can get the numbers equivalent and very near 100% — antibiotics only vs. surgery — what surgeon is going to risk the health (and potentially the lives) of that 10%?