The majority of children with uncomplicated acute appendicitis may be considered for either a non-operative or an operative management. The antibiotic-first strategy appears effective as an initial treatment in 97% of children with uncomplicated AA (recurrence rate 14%), with Non Operative Treatment (NOT) also leading to less morbidity, fewer disability days, and lower costs than surgery. In this trial, the investigators will compare children randomised in a surgery group with children randomised in a NOT group (antibiotic strategy group). Children have 2 on-site visits (including surgery) in the first 12 days with recording of clinical datas and questionnaires, a phone visit at month 1, month 6, month 12 to collect concomitant treatment, Adverse Event (AE) and complications and parental questionnaires at the end of the study. A Cost-Utility analysis will be performed from the healthcare payer's perspective. The time horizon of the medico economic analysis was one year.
Age from 5 to <15 years-old
an increase in the calibre of the appendix, measured at more than 6 mm in diameter and non-compressibility
free fluid, echogenic fat, regional hyperemia
performed in hospital or reviewed by local radiologist investigators if performed outpatient.
Ultrasound or CT scan showing one or several stercoliths, a plastron, an abscess or peritonitis
Non-visualization of the appendix at ultrasound or CT scan
Situations contraindicating surgery or anesthesia (patient for whom surgery and anesthesia would pose a life-threatening risk)
Patients who have already received antibiotic therapy for acute appendicitis