"I've heard of medically treated appendicitis, but if I'm involved, I'm going to perform an appendectomy. There's just too much at stake to avoid a simple procedure that has a low complication rate. I would never use anything other than the treatment of choice, only to have to worry for days about the patient. It stands against everything a General Surgeon represents in that it is heavily wieghted in the benefit zone of any risk-vs-benefit considerations."

The advent of diagnosing appendicitis via CT has allowed some physicians to avoid surgery for their patients by treating appendicitis with antibiotics. Of course, this is only possible via strict criteria, such as unruptured, etc. It seems to have become a popular subject in Pediatrician circles, but it is assuredly unpopular in General Surgeon circles for a couple of reasons: 1) Surgery is what you do, and 2) Although unruptured appendicitis will probably respond to antibiotics when so treated according to the prerequisite criteria, the treatment of choice for appendicitis is still removal. Don't be afraid to side with your specialty on this one. Also, looking at it from the hospital's point of view, a 'negative app' is a lot easier to explain than a child who dies because of an overly conservative approach. Rest assured, hour hospital will side with your specialty, too.

"I've been trained to know that removal of an appendix, even for something as isolated right lower quadrant pain, is acceptable and the proverbial abundance of caution."