Overview
Acute appendicitis is a common surgical emergency characterized by inflammation of the appendix. Uncomplicated appendicitis refers to inflammation without perforation or abscess formation.Diagnosis
Presumed uncomplicated acute appendicitis is an indication for appendectomy 1.
Exclusion criteria for studies on uncomplicated appendicitis include suspicion of perforated appendicitis 1.Management
Preoperative antibiotic treatment while awaiting surgery for presumed uncomplicated acute appendicitis may be considered 1.
Antibiotics are thought to decelerate inflammation progression and reduce complications in acute uncomplicated appendicitis 1.
Patients in a trial received cefuroxime (1500 mg) and metronidazole (500 mg) every 8 hours until surgery, with a single prophylactic dose given at anesthesia induction 1.
The Acute Care Surgery (ACS) model provides 24/7 nontrauma emergency surgical care 2.Key Recommendations
Preoperative antibiotic treatment may be administered to patients with presumed uncomplicated acute appendicitis while awaiting surgery 1. (Evidence: Moderate)
Antibiotics are believed to reduce complications in acute uncomplicated appendicitis 1. (Evidence: Weak)
The Acute Care Surgery model, providing 24/7 nontrauma emergency surgical care, is implemented worldwide with variations in components such as daytime on-site attending coverage and 24/7 in-house resident coverage 2. (Evidence: Moderate)References
1 Jalava K, Sallinen V, Lampela H, Malmi H, Steinholt I, Augestad KM et al.. Role of Preoperative Antibiotic Treatment While Awaiting Appendectomy: The PERFECT-Antibiotics Randomized Clinical Trial. JAMA surgery 2025. link
2 van der Wee MJL, van der Wilden G, Hoencamp R. Acute Care Surgery Models Worldwide: A Systematic Review. World journal of surgery 2020. link