Plasma Sodium as a predictor of perforation in acute appendicitis: A prospective multi-centre study

jpedsurg.org

The traditional perception of acute appendicitis (AA) as an inevitably progressive disease, always ending up in complex disease including perforation has been challenged. Early, emergent surgery is not always warranted in uncomplicated cases and non-operative treatment has been proven safe and feasible1-3. There is emerging consensus on two types of AA: one with mild inflammation, possibly managed with antibiotics or even non-antibiotic, non-operative treatment, and another more severe type with fulminant inflammation and subsequent risk of gangrene and perforation, where surgical removal is first line treatment4.

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Article · Apr 2026 · 1 min read

In brief

This prospective multi-centre study investigates plasma sodium levels as a potential biomarker to predict appendiceal perforation in acute appendicitis. The research addresses the clinical need to distinguish between uncomplicated cases suitable for non-operative management and severe cases requiring urgent surgical intervention.

Acute appendicitis exists as two distinct types: mild inflammation amenable to non-operative management and severe inflammation requiring surgery.
Early emergent surgery is not always necessary for uncomplicated appendicitis; non-operative treatment has proven safe and feasible.
The traditional view of appendicitis as inevitably progressive to perforation has been challenged by current evidence.
Severe appendicitis with fulminant inflammation carries risk of gangrene and perforation, warranting surgical intervention as first-line treatment.

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