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Comment & Response
May 1, 2019

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

Author Affiliations
  • 1Department of Surgery, Veterans Affairs Boston Healthcare System, Harvard Medical School, Boston, Massachusetts
  • 2Department of Surgery, Boston University, Boston, Massachusetts
JAMA Surg. 2019;154(8):783. doi:10.1001/jamasurg.2019.1059

In Reply Acute appendicitis presents as a spectrum varying in severity from uncomplicated (acute suppurative) to moderately severe (acute gangrenous) to severe (perforated with abscess). The traditional treatment was open appendectomy for all forms of appendicitis and has evolved to same-day laparoscopic surgery in most instances. With the frequent use of ultrasonography and computed tomography in the diagnosis of acute appendicitis and advances in interventional radiology, the treatment of perforated appendicitis with peri-appendiceal abscess evolved to percutaneous drainage and interval appendectomy.

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