Manejo atual da apendicite aguda não complicada : tratamento cirúrgico vs. conservador

Abstract

Acute appendicitis is an inflammation of the vermiform appendix, often caused by obstruction of the appendiceal lumen by feces, foreign bodies, or neoplasia. Although it is a well-known disease, its clinical presentation can vary considerably, making early diagnosis a crucial challenge for the effectiveness of treatment. In addition to appendectomy, which has been the mainstay of intervention for acute appendicitis and which can be performed by open laparotomy or laparoscopy, antibiotic administration has been a standard practice in the management of uncomplicated acute appendicitis. Laparoscopic appendectomy has gained popularity due to its benefits, such as less postoperative pain and faster recovery compared to the open approach. However, complications such as appendiceal perforation, abscess, and peritonitis can occur if treatment is delayed, resulting in increased morbidity and prolonged recovery time. Antibiotic therapy may be administered before or after surgery, depending on the severity of the condition. In some cases, especially in uncomplicated appendicitis, antibiotic treatment alone has been investigated as an alternative to surgery, showing promising results but with high recurrence rates and the advantage of low complication rates. Therefore, effective management of acute appendicitis requires early diagnosis and appropriate treatment to minimize complications and improve clinical outcomes for patients. Continued research into new therapeutic approaches and management strategies promises to further enrich the understanding of this common condition, offering better options for patients worldwide.