The authors report on a female patient who was simultaneously diagnosed with COVID-19 and appendicitis (1). We wonder why in this special situation it was not first attempted to treat the patient with antibiotics and prevent exposure of the patient to members of the staff involved in the surgery and especially in the intubation procedure. The antibiotic therapy of uncomplicated appendicitis has a success rate of about 90% in the early stage of the condition (2). While it is true that the effectiveness of conservative treatment is significantly lower in the long term, surgery to treat a recurrence of appendicitis, which occurs in about 20% to 40% of patients, could have been performed without concomitant COVID-19 disease. Special circumstances which would preclude conservative management in the presented case are not mentioned in the article. Thus, we hope that the decision to treat the patient surgically was made based on patient-specific considerations and not only because surgical traditions were adhered to.
Dr. med. Peter Becker
Prof. Dr. med. Dieter Schilling
Klinik für Gastroenterologie, Hepatologie und Endokrinologie
|1.||Schreckenbach T, Lahrsow M, Fritsch N: SARS-CoV-2 pandemic—a complicated case of appendicitis. Dtsch Arztebl Int 2020; 117: 364 VOLLTEXT|
|2.||Bhangu A, Soreide K, Di Saverio S, Assarson JH, Drake FT: Acute appendicitis: modern understanding of pathogenensis, diagnosis, and management. Lancet 2015; 386: 1278–87 CrossRef MEDLINE|