Treatment of acute appendicitis consists in the removal of the inflamed vermiform appendage; since lethality increases with delayed treatment, 10% of negative appendectomy is considered quite acceptable. The surgeon usually removes the outgrowth, even if it is perforated. Sometimes it is difficult to determine the location of the appendage: in these cases, the process usually lies behind the blind or ileum, as well as the mesentery of the right flank of the large intestine.
Contraindication to the removal of the process are inflammatory bowel diseases involving the cecum. However, in cases of terminal ileitis with an unchanged cecum, the process must be removed.
Removal of the process should be preceded by intravenous administration of antibiotics. Preferably - the third generation cephalosporins. With uncomplicated appendicitis, further use of antibiotics is not required. If perforation has occurred, antibiotic therapy should be continued until the patient's body temperature and leukocyte formula normalize (approximately 5 days). If surgical operation is not possible, antibiotics, although not a method of treatment, significantly improve survival. Without surgical treatment or antibiotic therapy, lethality reaches more than 50%.
In case of detection of a large inflammatory volumetric education with involvement of the appendix in the process, the distal part of the ileum and cecum, resection of the entire formation and ileostomy is preferable.
In neglected cases in which a pericolic abscess has already formed, the latter is drained by a tube transdermally under the supervision of an ultrasound or an open operation (followed by a delayed removal of the shoot). Meckel's diverticulum is removed in parallel with the removal of the process, but only if the inflammation around the process does not interfere with this procedure.