Evaluation of conservative management of acute appendicitis in tertiary care hospital

Introduction: Acute appendicitis is one of the commonest causes of acute abdomen with life time risk of 7-8 %. Appendectomy is the most favored treatment of appendicitis in most of the cases. Even after clinoradiological diagnosis 10 percent of cases after appendectomy appendix are found normal. Considered safe and routine surgery few patients develop complications of surgery like recurrent pain, obstruction, wound complications and rarely fistula and death. There are many studies showing encouraging results of conservative management of selective cases of appendicitis. Aim: Main aim of the present study was to know efficacy of conservative management of selective cases of acute appendicitis and long term symptoms free period of treated cases. Materials and methods: Present study was done in Surgery Department of GMERS Medical College, Gandhinagar between years 2011-2013. Selected 30 cases above 15 years of age with both sexes were managed conservatively on OPD and indoor. All patients were given antibiotics and symptomatic treatment. Follow up of all cases were done for 2 years after attack of appendicitis. Patients were informed to report immediately if symptoms reappears, or patients operated appendectomy outside. Inclusion criteria were patients above 15 years of age, history of attack less than 72 hours, first attack of appendicitis and exclusion criteria were patient having guarding and rigidity, perforation, appendicular lump, appendicular abscess and peritonitis. Results: Six patients did not respond to conservative management as symptoms worsens or remain same after completion of treatment and operated. More 3 patients operated in follow up period. There was no case of complication like perforation or abscess formation in operated cases. No case of mortality in this study was found. Conclusion: Selected cases of acute appendicitis can be managed conservatively with taking patient in confidence and proper communication and follow up.