**11. What should contain the conservative management of acute appendicitis?**

Admission in the hospital, and active observation according to the needs of the patient. Collection and estimation of inflammatory markers and imaging data. Soft *Acute Appendicitis: After Correct Diagnosis Conservative Treatment or Surgery? DOI: http://dx.doi.org/10.5772/intechopen.95870*

feeding is permitted if there is not nausea, intestinal obstruction or planning for operation. Correction of fluid imbalances due to inflammation. The use of antibiotics is mandatory as is the main therapy in conservative treatment. Antibiotic treatment is performed, according to the instructions for the treatment of intraabdominal infections [34] and a short scheme of 4 days may be effective, at least in uncomplicated cases. After conservative treatment, an interval time for further intervention tend to be abandoned [35] even more for complicated cases with abscess or phlegmon.

#### **12. Recurrence after conservative treatment**

The re-appearance of acute appendicitis after conservative treatment is not easy to be calculated. Most reports mention a percentage of 7–10% with a long period of follow-up [36]. There is a lack of information and heterogeneity about the kindresults of conservative treatment (during the first episode of acute appendicitis). Usually, surgery is followed after a new episode. The pathology report should describe changes of acute appendicitis and not chronic inflammatory changes in mucosa or sub-mucosa, as is the case after appendectomy due to recurrent episodes.

### **13. Conclusions**

Conservative treatment of patients with acute appendicitis is not very popular in surgical community, despite ongoing literature data supporting its role in the majority of patients with uncomplicated and selected cases of complicated acute appendicitis. Uncomplicated cases accounts for the 80–90% of patients with acute appendicitis. At every day's practice, more than 90% of uncomplicated cases undergoing appendectomy and less than 10% are treated conservatively. Conservative treatment should be offered, as an initial approach, to every patient with acute appendicitis. Surgeons should understand that the majority of patients may not need and they do not benefit from appendectomy.

#### **Conflict of interests**

The authors declare no conflict of interest.

#### **Abbreviations**

