Appendicitis is the most common abdominal surgical emergency worldwide, affecting both males (8.6% lifetime risk) and females (6.9% lifetime risk). Traditionally, open appendectomy was the standard treatment. However, contemporary management has evolved. Laparoscopic appendectomy now surpasses open surgery in usage, and some patients with nonperforated appendicitis may benefit from initial antibiotic therapy followed by interval appendectomy. In this strategy, patients receive antibiotics to avoid immediate surgery, reserving appendectomy for non-responders or those with recurrent symptoms. While nonoperative management offers expedited recovery and reduced time away from work, patients must accept uncertainties related to disease progression and potential missed neoplasms. For patients with perforated appendicitis, emergency appendectomy is performed promptly, while those without rupture may undergo a delayed appendectomy, also known as an interval appendectomy. The timing of appendectomy varies, as patients present with appendicitis at all hours of the day.
This post discusses a study on acute uncomplicated appendicitis, comparing the under 8 hours and under 24 hours approach in terms of in-hospital stays and risk of perforation.
and the results were :
In patients with presumed uncomplicated acute appendicitis, scheduling appendectomy within 24 hours does not increase the risk of appendiceal perforation compared with scheduling it within 8 hours. These findings can guide the allocation of operating room resources, allowing for strategic decisions such as postponing nighttime appendectomy to daytime.
Resources:
https://doi.org/10.1016/s0140-6736(23)01311-9
https://www.uptodate.com/contents/management-of-acute-appendicitis-in-adults
