Evaluation of conservative management of uncomplicated acute appendicitis in a rural medical college

Acute appendicitis is one of the commonest causes of acute abdomen with life time risk of 7-8%. Currently appendectomy is the favored treatment for acute appendicitis. However, there is wide discussion and controversy on the surgical and nonsurgical treatment of acute uncomplicated appendicitis. Objectives: The study was conducted to evaluate the efficacy and outcomes of the conservative management of uncomplicated cases of acute appendicitis. Materials and methods: The study was done in department of surgery, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam, india, a rural medical college & hospital from January 2014 to December 2016. Patients above the age of 16 yrs with clinical and radiological features of acute appendicitis presenting within 72 hrs of the beginning of abdominal pain were included. All patients received broadspectrum antibiotics and symptomatic treatment. The followup period was 1 year. Patients were informed to report immediately if symptoms reappear or patients underwent appendectomy outside. Results: out of the 45 patients evaluated, 27(60%) patients were female and 18 (40%) patients were male with mean age 34 years. Conservative treatment was effective in 34(75.5%) patients and failure encountered in 11(24.4%) patients. No mortality recorded in this study. The main complications which occurred in those patients who failed to respond to conservative treatment were perforated appendicitis (1 patient), appendicular abscess (1 patient) and appendicular lump (2 patients). Conclusion: selected cases of uncomplicated acute appendicitis can be treated successfully by conservative treatment. However, conservative treatment needs close monitoring and followup along with proper communication to the patient.