Appendicitis Pathway Background and Objectives Abdominal pain is a common reason for presentation to the Emergency Department, pediatric and surgical offices, and appendicitis is a common surgical etiology for this type of pain. Over the years, the American Pediatric Surgical Association has altered their guidelines for the management of pediatric appendicitis to help decrease the following: number of CT scans used for diagnosis, inappropriate antibiotic choices and duration, need for inpatient management post-operatively. Additionally, evidence now supports non-operative management of simple appendicitis under certain conditions. The Connecticut Children’s clinical pathway was developed to ensure an optimal consistent approach to the surgical management of children who present with appendicitis. The specific objectives of this pathway are: To standardize care of patients with both acute simple (non-perforated) appendicitis, complicated (acute perforated) appendicitis in the pediatric population To delineate guidelines on when to consider operative vs non-operative management To standardize care of patients with operative and non-operative management To provide evidence-based recommendations for key elements of care for appendicitis To clearly delineate discharge criteria and instructions Algorithm Download Appendicitis Pathway Algorithm – Updated September 14, 2020 Quality Metrics: Percentage of eligible patients treated per pathway Percentage of eligible patients with appendicitis order set usage Percentage of patients with appropriate post-op antibiotic selection Average duration of post-op antibiotic course (days) for complicated appendicitis Mean length of stay (simple, complicated stratified) Educational Module Download Appendicitis Educational Module Key References Craig S, Brenner B, et al. Appendicitis Practice Essentials. Medscape. July 23, 2018. Lee SL, Islam S, Cassidy LD, Abdullah F, Arca MJ. Antibiotics and appendicitis in the pediatric population: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review. J Pediatr Surg. 2010;45(11):2181-5. Pathway Contacts Christine Rader, MD Brendan Campbell, MD, MPH Disclaimer The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case. View all Clinical Pathways >
