Can Fam Physician. 2018 Aug;64(8):574-576.
A 10-year-old girl who was seen in my office last week with acute-onset abdominal pain and fever was referred to an emergency department, was diagnosed with appendicitis, and was treated conservatively with antibiotics, without surgery. Has the paradigm for treating appendicitis changed, and which is the preferred treatment of appendicitis in children: antibiotics or appendectomy? For more than 100 years, surgical management was the principal treatment of acute appendicitis. Potential adverse events associated with appendectomy include bleeding, surgical site infection, and ileus, as well as stress for children and their parents. The option of treating appendicitis with antibiotics has been known for decades, which has led to consideration of antibiotics alone as a therapeutic alternative to surgery for uncomplicated appendicitis. While there is a reasonable body of evidence in support of this practice in adults, the accumulation of evidence of the safety and effectiveness of non-operative management in children is ongoing. Large studies are still needed, and those are being conducted at this time, with results expected in the next few years.
一位 10 岁女孩上周因急性腹痛和发热到我的诊室就诊，被转至急诊，被诊断为阑尾炎，给予抗生素保守治疗，未行手术。阑尾炎的治疗模式是否已经改变，儿童阑尾炎的首选治疗方法是抗生素还是阑尾切除术？100 多年来，手术治疗一直是急性阑尾炎的主要治疗方法。阑尾切除术相关的潜在不良事件包括出血、手术部位感染和肠梗阻，以及儿童及其父母的压力。用抗生素治疗阑尾炎已经有几十年的历史了，这使得人们考虑将抗生素单独作为治疗复杂阑尾炎的手术替代方法。虽然在成人中，这种做法有合理的证据支持，但仍在不断积累非手术治疗儿童阑尾炎的安全性和有效性证据。仍需要进行大型研究，目前正在进行中，预计在未来几年内会有结果。
