SPONTANEOUSLY RESOLVING ACUTE APPENDICITIS - CLINICAL AND SONOGRAPHICDOCUMENTATION

PURPOSE: To document findings in a subgroup of patients with acute app endicitis that spontaneously resolved. MATERIALS AND METHODS: From Feb ruary 1989 through December 1995, nine patients were seen with a diagn osis of acute appendicitis that did not necessitate immediate surgery. Clinical, ultrasound (US), and pathologic findings were retrospective ly reviewed. RESULTS: Four of the nine patients underwent elective app endectomy 15-84 days (mean, 52 days) after initial presentation, and f ive did not undergo surgery. Seven patients experienced spontaneous pa in relief before admission to the hospital, and two improved within a few hours of being admitted. No patient had an indication of peritonea l irritation at physical examination. Four patients had a normal white blood cell count, and five had leukocytosis. Maximum appendiceal diam eter was 9-12 mm. Five patients had inflamed periappendiceal fat. No p atient had abscess or appendicolithiasis shown at US. A normal appendi x was identified at follow-up (mean, 40 months; range, 1-60 months) in four of five patients who did not undergo elective appendectomy. Two patients experienced recurrent bouts of pain, and one of these patient s underwent appendectomy before the planned elective procedure. CONCLU SION: On the basis of clinical, US, and pathologic findings, mild acut e appendicitis spontaneously resolved in a subgroup of patients.