Childhood Appendicitis – Antibiotic Trial to Commence at Southampton
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As a lawyer specialising in Clinical Negligence claims for the past 13 years, I have dealt with a number of cases concerning a delay in diagnosis and treatment of appendicitis. Historically it was believed that the correct way to treat individuals with acute appendicitis was to surgically remove the appendix.
Claims would arise where the treatment was delayed to the extent that the appendix burst before it could be removed, which usually means that the patient has to undergo open surgery rather than keyhole surgery, involving greater scarring, increased risks and a prolonged recovery time.
However in more recent years there has been a slight shift in expert medical opinion. Many doctors now consider that antibiotic therapy and careful close monitoring of adult patients is a reasonable first approach. A number of patients do respond to such conservative management, avoiding the need for surgery altogether.
Appendicitis is though generally thought to be potentially more serious in children and the standard approach is to have a low threshold for admission to hospital followed by surgical removal of the appendix.
However, it was reported in the Southern Daily Echo last week, that the Paediatric unit at Southampton General Hospital is leading a study across four paediatric units in England, looking at the comparative effectiveness of antibiotic therapy in children presenting with acute appendicitis. This is reported to be a randomised study over a year long period, although presumably it goes without saying that all children will be very closely monitored and surgery performed if necessary. If surgery can be avoided though, this means that children will be spared the trauma of having to go through surgery, and the attendant complication risks that all surgery carries.
Regardless of the approach adopted, in my experience the critical issue when caring for patients with suspected appendicitis is to examine and monitor the patient very closely and to respond quickly to any changes in their condition.
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