Background and Objective: Acute appendicitis is traditionally treated with operative approaches. The
latest progress in diagnostic techniques has coincided with the introduction of novel non-invasive treatment
options. Original studies on this subject indicate that non-operative management of acute appendicitis in the
children population is feasible. This review explores current literature on the efficacy, safety, and long-term
outcomes of non-operative treatments and gives an overview of this management method.
Materials & Methods: In the pursuit of conducting this narrative review, a systematic search was
performed utilizing the Scopus, Embase, ISI, and Google Scholar databases. The inclusion criteria comprised
original articles, review papers, and meta-analyses that focus on the non-surgical treatment of acute
appendicitis in the pediatric population. This investigation adopted a descriptive-analytical approach. All
pertinent literature was meticulously evaluated, and data were carefully extracted; the findings and insights
obtained from these sources were subsequently incorporated into various sections of this review.
Results: Non-operative management has been reported to have a lesser length of hospital stay and a
better patient satisfaction rate in comparison to operative management. Key factors in selecting the
appropriate patients for non-operative management include younger age, lesser symptoms and fever
durations, mild clinical presentations, lower white blood cell and CRP levels on laboratory studies, and lower
appendix diameter on imaging. Further Randomized Controlled Trials with longer follow-up durations and
similar antibiotic administration are required to address the heterogeneity of previous research.
Conclusion: Existing evidence from previous studies advocates for the non-surgical management of
uncomplicated acute appendicitis in children. However, it is imperative to establish comprehensive
guidelines for patient selection. Such guidelines are essential to mitigate the risk of misdiagnosis and to
prevent the occurrence of serious complications stemming from inadequate management.