When acute appendicitis presents with preoperative evidence of abscess formation or perforation, it is classified as complicated appendicitis — a clinical distinction that directly shapes the management strategy for both adult and pediatric patients.
Current evidence-based guidance recommends operative management as the primary approach for this scenario, with specific intraoperative and postoperative antibiotic considerations — the complete protocol details are available via the link below.
Complicated appendicitis was defined as cases with preoperative evidence of abscess or perforation.
The panel suggests that adult and pediatric patients with complicated appendicitis be managed operatively (conditional recommendation based on very low certainty of evidence in adults and low certainty of evidence in pediatrics).
The panel suggests that adult and pediatric patients who have undergone appendectomy for complicated appendicitis should be treated with short-term antibiotics postoperatively (conditional recommendation based on very low certainty of evidence).
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