Problems in the Treatment of Acute Appendicitis

Abstract

In order to clarify the prognosis and problems in the conservative treatment of mild appendicitis, 289 patients with acute appendicitis admitted from January 1985 to July 1987 were studied. Of the 289 patients, 67 attained remission by the conservative treatment and 222 underwent laparotomy, 25 (11%) of which were revealed other diseases after laparotomy. One hundred and ninety-seven surgical cases except these 25 were diagnosed surgically and pathologically as catarrhal appendicitis (8%), suppurative appendicitis (38%), gangrenous appendicitis (22%), and perforated appendicitis (32%), indicating a few occurrence of catarrhal type. Two (3%) cases fell into perforation during the palliative treatment. Ten (17%) patients were undergone surgery under the diagnosis of recurrent appendicitis after discharge, whose symptoms had once improved by the conservative treatment. However, questionnaire survey asking current status after the conservative treatment revealed that 47 cases which accounted as much as 80% of non-operative cases answered to be satisfied with the conservative treatment. Recurrence necessitating surgery was noted in 4.9% of the subjects.