Risk Factors of Failure of Conservative Treatment in Acute Non Complicated Appendicitis

Not yet recruiting

• Conditions: Conservative Management
• Interventions: Drug: ceftriaxone; Drug: ceftriaxone 1 gm/12 hourly and IV metronidazole 500 mg/8 hourly

• Registration Number: NCT06828952
• Lead Sponsor: Ahmed Mohammed Hussein Sayed

Brief Summary

From this study, it can be concluded that patients who meet the following criteria are more likely to fail expectant management and thus should not be considered for the NOM of uncomplicated acute appendicitis. These include the duration of symptoms before presenting to a surgical emergency , the presence of fever within 24 hours of presenting to a surgical emergency, TLC cells/dL, CRP mg/L, appendix diameter mm, modified Alvarado score , and adult appendicitis score .

Detailed Description

Expectant management with intravenous antibiotic therapy alone has emerged as an effective alternative to appendectomy for the treatment of uncomplicated acute appendicitis . It is important to identify patients at the onset of the disease who are likely to have successful outcomes for conservative management.

Study Timeline

• Status Verified: 2024-12
• Study First Submitted: 2024-12-04
• Study First Submitted QC: 2025-02-13
• Last Update Submitted: 2025-02-13
• Study First Posted: 2025-02-17
• Last Update Posted: 2025-02-17
• Study Start: 2025-06-22
• Primary Completion: 2025-12-01
• Study Completion: 2025-12-02

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

• Male or female patients é diagnosis of acute appendicitis .
• Patients with ages: from 16 to 60 years old.

Exclusion Criteria

• complicated AA (appendicolith, perforation, peri appendicular abscess or suspicion of a tumor).
• inflammatory bowel disease.
• inability to co-operate and give informed consent.
• diffuse peritonitis.
• antibiotic documented allergy & allergy to contrast media .
• Patients with serious comorbid conditions DM & renal insufficiency, serum creatinine > 150 μmol/l .
• Pregnant & lactating patient.
• Patients with bleeding diathesis and those on anticoagulants.
• Patients with advanced malignancies & patient on immunosuppressive drugs .
• Patients with previous appendectomy.
• Extreme of age.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
(1) Male or female patients é diagnosis of acute appendicitis.	ceftriaxone	Patients who presented with complaints of right lower quadrant pain with symptoms and signs strongly suggestive of uncomplicated acute appendicitis that was confirmed on ultrasonography, were included. The modified Alvarado score and adult appendicitis score were calculated.
(1) Male or female patients é diagnosis of acute appendicitis.	ceftriaxone 1 gm/12 hourly and IV metronidazole 500 mg/8 hourly	Patients who presented with complaints of right lower quadrant pain with symptoms and signs strongly suggestive of uncomplicated acute appendicitis that was confirmed on ultrasonography, were included. The modified Alvarado score and adult appendicitis score were calculated.

Primary Outcome Measures

Name	Time	Method
Risk factors of failure of conservative treatment in acute non complicated appendicitis	One year	modified Alvarado score and adult appendicitis score

Trial Locations

Locations (1)

Assiut University; 🇪🇬 Assuit, Egypt