Management of uncomplicated acute appendicitis in pediatric and adult patients: Systematic review
DOI:
https://doi.org/10.16921/pfr.v10i3.390Keywords:
acute appendicitis, antibiotic treatment, appendectomy, recurrenceAbstract
Introduction: Acute appendicitis is a common cause of acute abdomen and is classified into uncomplicated and complicated forms. Traditionally, it is treated with appendectomy, although antibiotic treatment has gained ground in uncomplicated cases. There are clinical differences between adults and children that affect diagnosis and management, and it is more difficult to identify in children under 5 years of age.
General objective: To analyze the management strategies for uncomplicated acute appendicitis in pediatric and adult patients, comparing the results of antibiotic treatment and appendectomy according to current scientific evidence.
Methods: A systematic review of scientific literature published between 2020 and 2025 on the management of uncomplicated acute appendicitis in adults and children was conducted. Studies were searched in databases such as PubMed, Cochrane, Scopus, and Embase. Recurrence, complication, hospitalization, and recovery rates were analyzed, differentiating between pediatric and adult populations.
Results: Of 1,243 articles found, 31 studies met the criteria and were included in this review. A total of 2,612 patients with uncomplicated appendicitis, both pediatric and adult, were analyzed. Fifty-five percent were men and 45% were women. Surgical treatment was primarily laparoscopic, while conservative management consisted of intravenous antibiotics followed by oral antibiotics. In adults, conservative treatment had a success rate of 68–75%, while in children it was higher at 82–87%. Recurrence was higher in adults (27–30%) than in pediatric patients (12–15%). Surgical complications were minimal in both groups, and hospitalization was shorter with surgery. Mortality was low (<0.1%) and not directly related to appendicitis.
Conclusion: Antibiotic treatment for uncomplicated appendicitis showed good results in both adults and children, with a higher initial success rate and lower recurrence in the pediatric population. However, in adults, there were more recurrences and complications, especially in the presence of appendicoliths. This highlights the need for careful patient selection and further long-term studies in both populations.
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