Is surgery necessary for appendicitis?

Not all cases of appendicitis require immediate surgery. Appendicitis can be categorized into several types based on the severity of inflammation: simple appendicitis, suppurative appendicitis, gangrenous appendicitis, and appendiceal perforation. For simple appendicitis or mild suppurative appendicitis, where the inflammation is relatively mild, non-surgical treatments such as appropriate antibiotic therapy for infection control, anti-inflammatory medications, pain relief, antiemetics, antidiarrheals, and fever reduction may effectively control the inflammation, alleviate symptoms, and even lead to recovery.

If the inflammation is severe, such as in gangrenous appendicitis or appendiceal perforation, the condition is often acute and serious. Patients may experience severe abdominal pain localized to the lower right quadrant or throughout the entire abdominal cavity, along with persistent high fever and other symptoms. In these cases, non-surgical treatment may be ineffective and could potentially delay treatment, leading to severe complications.

With advances in medical technology, non-surgical treatment combined with close monitoring has shown certain effectiveness for selected cases of acute simple appendicitis. However, strict patient selection is crucial, and close observation of the disease progression during treatment is necessary to avoid delaying the optimal timing for surgery.