Kupietzky Amram, Bar-Moshe Yehonatan, Lavie Nofar, Drayer Lichtman Moriya, Dover Roi, Juster Eyal Yonathan, Maden Ata, Mazeh Haggi, Mizrahi Ido
Department of Surgery, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91240, Israel.
Department of Radiology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91240, Israel.
World J Clin Cases. 2025 Aug 16;13(23):106532. doi: 10.12998/wjcc.v13.i23.106532.
Non-operative management (NOM) for uncomplicated acute appendicitis (AA) has been gaining popularity in recent years. One of the major concerns with NOM is the recurrence rate of AA following NOM.
To investigate the impact of the presence of an appendicolith and its specific characteristics on the recurrence rate of AA following NOM.
A retrospective analysis identified all patients treated with NOM for AA, at our institute between 2016 and 2024. Patients with an appendicolith on imaging were identified and their course and outcomes were compared with patients who were treated with NOM without an appendicolith. The primary outcome was defined as a recurrence of AA.
During the study period, 797 patients were treated with NOM for AA. Their mean age was 25.4 years ± 14.4 years, and 45.4% were females. Only 68 patients (8.5%) had an appendicolith identified on imaging. Patients with an appendicolith had a larger appendix diameter (10.2 mm ± 4 mm 8.5 mm ± 2.1 mm, = 0.001). There was no difference in the recurrence rate of patients with and without an appendicolith (26.5% 19.1%, = 0.14), however patients with an appendicolith presented with a shorter time to recurrence of appendicitis (3.9 months ± 10.4 months 5.9 months ± 8.1 months, = 0.04). In a sub analysis, the number of appendicoliths, its size, and its location, did not influence the recurrence rate.
This study demonstrates that patients with appendicoliths have a shorter time to recurrence after NOM of AA, but do not experience higher overall recurrence rates.
近年来，非手术治疗（NOM）单纯性急性阑尾炎（AA）越来越受到欢迎。NOM的主要问题之一是NOM后AA的复发率。
探讨阑尾结石的存在及其特定特征对NOM后AA复发率的影响。
回顾性分析2016年至2024年在我院接受NOM治疗的所有AA患者。识别出影像学检查有阑尾结石的患者，并将其病程和结局与无阑尾结石接受NOM治疗的患者进行比较。主要结局定义为AA复发。
在研究期间，797例患者接受了NOM治疗AA。他们的平均年龄为25.4岁±14.4岁，45.4%为女性。只有68例患者（8.5%）在影像学检查中发现有阑尾结石。有阑尾结石的患者阑尾直径更大（10.2 mm±4 mm对8.5 mm±2.1 mm，P = 0.001）。有和无阑尾结石患者的复发率无差异（26.5%对19.1%，P = 0.14），然而有阑尾结石的患者阑尾炎复发时间更短（3.9个月±10.4个月对5.9个月±8.1个月，P = 0.04）。在亚组分析中，阑尾结石的数量、大小和位置不影响复发率。
本研究表明，有阑尾结石的患者在AA接受NOM后复发时间更短，但总体复发率并不更高。
