In the past, appendicitis has been considered a surgical emergency that requires prompt appendectomy to avoid perforation and other complications. However, evidence suggests that adverse outcomes (eg, perforation, complications, or operating time) are not increased for children who receive timely administration of antibiotics and undergo appendectomy less than 24 hours after diagnosis: A systematic review of observational data and subsequent meta-analysis of 2510 patients with acute appendicitis (539 children younger than 16 years of age) found no increase in the frequency of complex appendicitis in patients who had a delay of 12 to 24 hours after admission.
However, an increased risk of surgical site infection and 30-day complications occurred in patients for whom appendectomy was delayed beyond 48 hours after admission. In a multicenter, prospective observational study of 955 children…
