Can patients with acute appendicitis avoid surgery?

Whether surgery is required for patients with acute appendicitis depends on the severity of the condition and the patient's overall health status. Mild cases without complications may be treated conservatively, whereas severe conditions or those complicated by symptoms necessitate surgical intervention. If in doubt, early medical consultation is recommended. Detailed explanations are as follows:

If acute appendicitis is in its early stage with mild symptoms, such as slight tenderness in the right lower abdomen without rebound tenderness or abdominal muscle rigidity, normal or slightly elevated temperature, and insignificant increase in white blood cell count, conservative treatment may be attempted. Administration of intravenous antibiotics to control infection, along with fasting and fluid replacement, may lead to gradual resolution of inflammation in some patients. However, close monitoring is necessary during conservative treatment, and the treatment plan should be promptly adjusted if symptoms worsen.

When appendiceal perforation or gangrene occurs, or when diffuse peritonitis or intra-abdominal abscess develops, accompanied by severe pain in the right lower abdomen, high fever, chills, nausea, vomiting, or if the condition fails to improve or worsens after conservative treatment, prompt appendectomy is necessary. Delaying surgery in such cases may lead to severe complications, including septic shock and multiple organ dysfunction.

The selection of treatment strategies for acute appendicitis must strictly follow the judgment of professional physicians. Close monitoring throughout the course of conservative treatment is essential. Even if symptoms improve, regular follow-up examinations are required. Immediate medical attention should be sought upon detection of any abnormalities to avoid missing the optimal treatment window.