Abstract
Purpose: Inflammation in mild acute appendicitis may be relieved by conservative treatment, although recurrence remains a problem. We investigated the risk factors of recurrence with surgical specimens and follow-up ultrasonography (US) after conservative treatment of acute appendicitis.
Methods: The medical records of 126 consecutive patients with acute appendicitis treated conservatively between January 2005 and December 2010 were reviewed. We examined 1) pathology of the surgical specimens, and 2) followup US findings one month after conservative treatment.
Results: Recurrence was confirmed in 36 of 126 patients. The average period of recurrence was 258 days (range 13-1,505 days), and relapse occurred in 31 treated cases (86.1%) within one year. 1) Pathological findings showed stenoses of the appendix in 25 (69.4%), and swelling of the appendiceal tip in 18 (50.0%) treated cases. 2) Followup US after conservative treatment was established in 65 cases, in which 17 cases relapsed. The recurrence rate was significantly higher in patients who showed a swollen tip in US one month after discharge.
Conclusions: Recurrence of acute appendicitis after conservative treatment was higher in patients with stenosis of the appendix, and swelling of the appendiceal tip in the follow-up US.
