The Limitation of Conservative Therapy in Acute Appendicitis -The Criteria How to Foreknow It's Result-

Satoru Motoyama, Hideo Terashima*, Osamu Usuba*, Tomio Matsuoka*

Second Department of Surgery, Akita University School of Medicine
*Department of Surgery, Hiraka General Hospital

Of 206 patients with acute appendicitis who visited our hospital during the last 3 years and 9 months, 65 patients did not undergo immediate surgery: 50 were successfully treated conservatively (group A), and 15 underwent surgery after conservative treatment (group B). We compared group A with group B as to clinical course and examined the criteria how to foreknow the result of conservative therapy. On ultrasonographic examination, the cases whose ultrasonographic diagnosis was positive were 18.8% in group A, 86.7% in group B. On clinical course in group A, WBC had decreased to 60% on day 1,50% on day 2 incomparison with the WBC at admmition. C-reactive protein was less than 3 plus(3.2∼5.9 mg/dl)at admission and on day 1,and had decreased after day 2 or day 3. Body temperature was less than 37.0°C on day 1 and had decreased after day 2.There was not this tendency in group B.These results were usefull in how to foreknow the result of conservative therapy in acute appendicitis.

Key words
acute appendicitis, limitation of conservative therapy, foreknowledge of coservative therapy, ultrasonographic diagnosis, reccurence of appendicitis

Reprint requests
Satoru Motoyama Second Department of Surgery, Akita University School of Medicine
1-1-1 Hondo, Altita, 010 JAPAN

Accepted
January 12, 1994

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