Non-operative treatment of appendicitis: public perception and decision-making.

BACKGROUND: Appendectomy has for many years been the accepted treatment of appendicitis. In recent years, non-operative management of appendicitis (NOTA) has been reported as an effective treatment option. AIMS: We aimed to assess the perspectives of public hospital attendees regarding the diagnosis and treatment options for appendicitis. METHODS: We conducted a cross-sectional survey of outpatients over a 10-week period (December 2016-March 2017). The questionnaire contained an information sheet and consent form and included open, closed and multiple-choice questions. RESULTS: Two hundred forty-four participants (159 female, 85 male) were surveyed. A high level of awareness of appendicitis as a surgical emergency existed amongst the participants. The primary reason participants were reluctant to receive non-operative treatment was a fear of their appendix "bursting" if not removed. CONCLUSIONS: Participant knowledge levels were variable with many concerned that non-operated appendicitis would always perforate. Perceptions of treatment were variable with some believing surgery was an absolute requirement and others preferring antibiotics due to the belief that NOTA is complication-free.