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Comment & Response
May 1, 2019

Complicated and Uncomplicated Acute Appendicitis Are Different Diseases—Do Not Compare Apples With Oranges

Author Affiliations
  • 1Division of Digestive Surgery, Turku University Hospital, Turku, Finland
  • 2Department of Surgery, Oulu University Hospital, Oulu, Finland
JAMA Surg. 2019;154(8):782-783. doi:10.1001/jamasurg.2019.1056

To the Editor The Peri–Appendicitis Acuta (Peri-APPAC) randomized clinical trial1 compared interval appendectomy with follow-up with magnetic resonance imaging after initial successful nonoperative treatment of complicated acute appendicitis (CAA) presenting with a periappendicular abscess evaluating the necessity of an interval appendectomy after the initial treatment. We found an alarmingly high rate of appendiceal neoplasms first detected in interval appendectomies, prompting premature trial termination supporting routine interval appendectomy in this setting.

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