Antibiotics For Appendicitis May Save Thousands From Surgery To Remove Appendix

Antibiotics For Appendicitis May Save Thousands From Appendectomy
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People who suffer from acute appendicitis may be successfully treated with antibiotics and not have to undergo a surgical operation to remove their inflamed appendix, researchers of a new study have reported.

In the United States alone, there are about 300,000 appendix removal operations performed each year. Figures from The National Institute of Diabetes and Digestive and Kidney Diseases also show that more than 5 percent of the population develops appendicitis at some point. Anyone can develop appendicitis, but it most commonly occurs in individuals who are in their teens and 20s.

Turku University Hospital surgeon Paulina Salminen, however, said that most cases of appendicitis are not complicated, which means that the organ has not ruptured. These cases can be treated with antibiotics. An operation only becomes necessary once the appendix looks like it may burst immediately.

Salminen said that while 20 to 30 percent of patients with appendicitis have a perforated appendix, 70 to 80 percent of the patients need only antibiotics. A perforation is a small tear in the appendix that can cause its contents to leak out into the stomach and possibly lead to fatal blood infection.

In a new study, which was published in the Journal of the American Medical Association on Sept. 25, Salminen and colleagues involved 273 patients who underwent an appendectomy, the surgical operation to remove the appendix, and 257 patients who were treated with antibiotics.

Appendicitis Patients May Not Need Appendectomy To Treat Inflamed Appendix
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During the follow-up period, 70 patients treated with antibiotics underwent an appendectomy within their first year. Another 30 patients from the group underwent an appendectomy over the course of the five-year study. Overall, the patients who were initially treated with antibiotics for uncomplicated acute appendicitis only had a little over 39 percent risk for late recurrence within five years.

The findings contradict decades of thinking about how to best treat an inflamed appendix. Salminen also said that the results of the study suggest that thousands may be spared the inconvenience of operations to remove the appendix. An appendectomy happens to be one of the most common emergency surgeries performed worldwide.

“We need to change the line of thinking that has persisted over a hundred years that acute appendicitis always progresses to perforation and thus always requires emergency appendectomy,” Salminen said in an interview with Contagion.“Long-term antibiotic therapy is a feasible option and an alternative to surgery in patients with uncomplicated acute appendicitis.”

CT scans now make it easier to determine whether an appendix may burst, or the patient can be safely treated with antibiotics.