Authors´ conclusions: nonoperative management of nonperforated pediatric appendicitis in children has increased in the U.S.A. in recent years. Although most patients are treated successfully, they have a higher rate of emergency department revisits and hospitalizations than children who have appendectomy on their first visit and, in whom non-surgical management fails, there is an increased risk of perforation.
Reviewers´ commentary: nonoperative management of nonperforated pediatric appendicitis has increased in U.S.A. children's hospitals between 2011 and 2020. Although most children are successfully treated, this study suggests bigger rates of subsequent check-ups and hospitalizations, as well as an increased risk of perforation at the time of failure with that type of management. Further rigorous, large-scale studies of nonoperative management in children are needed to determine its optimal use.