Background: Acute appendicitis is one of the most common causes of acute abdomen pain. Gold standard treatment of acute appendicitis is the appendectomy. In this study, we investigated in selected cases whether antibiotherapy can be preferred instead of urgent surgery.

Material and Method: Patients who were admitted to the emergency room between January 1, 2016, and December 31, 2016, with abdominal pain and who were diagnosed with acute appendicitis as a result of physical examination, laboratory and radiological examination were divided into two groups. Patients who did not want to undergo surgery and received medical treatment were determined as group 1 antibiotherapy and who underwent appendectomy were determined as group 2. Physical examination, laboratory values, radiological examination results, scores according to the Alvarado scoring system, clinical follow-up data, receivedtreatment, complications were recorded. Hospitalization period, return period to work, post-treatment complaints, control findingsand laboratory values were compared.

Results: Of the 133 patients included in the study, 59 (44.4%) were female and 74 (55.6%) were male. Mean age was 42.8 (18-92 years). Whereas antibiotherapy was given 54 patients (group 1, 40.6%), 79 patients were urgently preparedfor appendectomy (group 2, 59.4%). No differences were found between the two groups in terms of gender. The mean age was 53.8 (18-93 years) in group 1 and 35.3 (18-71 years) in group 2. The mean erythrocyte was 14844 (4400-22000/mm³) in the group 1 and 11800 (6500-21000/mm³) in the group 2. The mean C-reactive protein was 64.5% in the antibiotherapy group and 39.9% in the appendectomy group. The mean appendicitis diameter was determined as 9.4 (6-13 mm) in the group 1, and as 8.5 (6-13 mm) in the group 2. The mean Alvarado scores were 8.62 inthe group 1 and8.51 in the group 2. None of the 43 patients in group 1 have had relapsed acute appendicitis and appendectomy has not been performed again, even in another center.

Conclusion: For acute appendicitis, patients who do not accept the operation for various reasons or who are at high risk of having surgery due to existing health problems, medical treatment approach instead of emergency surgery may be a safe and easy option.

Murat Kendirci