Clinical progress note: The evolving role of nonoperative management in uncomplicated pediatric appendicitis

Appendicitis is the most common pediatric surgical emergency across the globe. The historical approach emphasized early operation to prevent perforation, accepting negative appendectomies as an inevitable consequence. However, appendectomy comes with risk for postsurgical complications, and with improvements in imaging, early studies began to suggest nonoperative management (NOM) with antibiotics in low-risk patients with uncomplicated appendicitis. With growing use of NOM, we have expanding literature to show that NOM may not be as efficacious as previously implied, complicating the shared clinical decision making discussion with patients and their families.