Controversies Around Appendicitis Treatment (S6:E14)

Although acute appendicitis is the most common acute surgical condition experienced by children, multiple aspects of appendicitis management remain well-debated. Despite recent advancements — including scoring systems, imaging and antibiotics — the variations in management options remain topics of intense discussion.

Listen to pediatric experts discuss approaches to appendicitis treatment

In this episode, Lorraine Kelley-Quon, MD, joins us from Children's Hospital Los Angeles to discuss the appendicitis management debate. With no absolute consensus in the literature, controversy persists among surgeons and healthcare professionals.

In this episode, our experts discuss:

• Signs and symptoms of appendicitis and what happens if it’s not treated
• Two causes of appendicitis: appendicolith and lymphatic inflammation
• Association of family history with appendicitis and the “July effect”
• An overview of the scoring system and risk stratification
• Controversy #1: What are the optimal imaging approaches — ultrasound, CT scan or focused MRI?
• Controversy #2: Should non-operative management be offered to children?
• Controversy #3: Should children be prescribed opioids pre- or post-surgery?

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