The diagnostics of appendicitis is challenging. While some centers rely on routine imaging of every patient, some centers use different scoring systems to select patients for imaging. Ultrasound is usually the preferred first-line imaging, but due to low sensitivity, computed tomography (CT) is often needed to diagnose or rule out appendicitis. CT uses ionizing radiation, which increase the risk of cancer later in life. There is also compelling evidence that portion of appendicitis may be self-limiting and thus not needing any intervention at all. The aim of this multicenter randomized controlled trial is to assess whether 1) selective imaging can achieve low negative appendectomy and low perforation rate comparable to routine imaging, and whether 2) observation can be utilized after score-based selection of patients to allow resolution of appendicitis and reduce the need of surgery.

2024

2028