Surgery · Appendix, Small Intestine and Intestinal Obstruction

The NOTA study demonstrated that non-operative management (antibiotics alone) for uncomplicated acute appendicitis (no perforation, no abscess on CT) achieves successful short-term resolution in approximately what percentage of patients?

  • A 40–50%
  • B 60–70%
  • C 70–80%
  • D 90–95%
Correct answer: C. 70–80%

Explanation

Multiple trials including the NOTA study and APPAC trial have shown that antibiotic-only treatment for uncomplicated CT-confirmed acute appendicitis achieves initial treatment success in approximately 70–80% of patients at short-term follow-up. Recurrence risk is approximately 25–30% at 5 years in those initially treated successfully with antibiotics. Patients with a faecolith (appendicolith) on CT have significantly higher recurrence and failure rates and may be better served by appendicectomy. Patients must be counselled about recurrence risk when choosing non-operative management.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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