TY - JOUR AU - Abbo, Olivier; Trabanino, Carmen; Pinnagoda, Kalitha; Ait Kaci, Amir; Carfagna, Luana; Mouttalib, Sofia; Combelles, Sophie; Vial, Julie; Galinier, Philippe TI - Non-operative Management for Uncomplicated Appendicitis: An Option to Consider SN - 0939-7248 SN - 1439-359X PY - 2018 JO - Eur J Pediatr Surg JF - European Journal of Pediatric Surgery LA - EN VL - 28 IS - 01 SP - 018 EP - 021 ET - 2017/10/10 DA - 2018/01/19 KW - appendicitis KW - non-operative management KW - antibiotics AB - Aim The main goal of our study was to assess a 7 days long course of antibiotics for acute uncomplicated appendicitis.Materials and Methods From March 2014 to November 2015, all patients diagnosed with acute appendicitis have been considered to be treated by only antibiotics. Inclusion criteria included clinical (tenderness), biological (C-reactive protein [CRP] < 50), and radiological features (diameter > 6 mm). All patients were treated with intravenous amoxicillin and clavulanic acid (100 mg/kg/day) for 2 days (six doses). At the end of the treatment, clinical and paraclinical examinations included blood samples at day 7 and ultrasound (US) scan at 3 months.Results A total of 166 patients were treated and followed up prospectively during the study period. Mean age at diagnosis was 10.8 ± 0.6 years. All children, but four were discharged with a clinical improvement after 48 hours and six intravenous antibiotics injection according to our protocol. Four children required surgery during the initial hospitalization period.Initial ultrasound scan showed a mean diameter of 7.85 ± 1.6 mm, with inflamed fat in 124 patients (74.7%). At Day 7, the diameter was 5.2 ± 1.6 mm (p < 0.0001).During a median follow-up of 18.8 months (3.5–18), 22 patients (13.25%) had to be managed for a novel episode of acute appendicitis after a median period of 138 days (13–270). None had to be managed for a complicated appendicitis.Conclusion Non-operative treatment (NOT) is a safe alternative for the management of uncomplicated acute appendicitis in children. Further study should be conducted to determine relapse risk factors. PB - Georg Thieme Verlag KG DO - 10.1055/s-0037-1607292 UR - http://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0037-1607292 ER -