Please select the eligibility criteria that correspond to the clinical trial below.
Title: Study of Surgical Treatment (Open Appendicectomy) Versus Antibiotic Treatment (Ertapenem) in the Treatment of Acute Uncomplicated Appendicitis
Brief Summary: Appendicectomy has been the treatment of acute appendicitis for over a hundred years. Appendicectomy, however, includes operative and postoperative risks despite being a "routine" operation. At the same time other similar intra-abdominal infections, such as diverticulitis, are treated with antibiotics. There have been some encouraging reports on successful treatment of appendicitis with antibiotics and it has been estimated that operative treatment might be necessary for only 15 - 20 % of patients with acute appendicitis.

The aim of this randomized prospective study is to compare operative treatment (open appendicectomy) with conservative treatment with antibiotics (ertapenem, Invanz). Before randomization acute uncomplicated appendicitis is diagnosed with a CT scan.The hypothesis of the study is that the majority of patients with uncomplicated acute appendicitis can be treated successfully with antibiotics and unnecessary appendicectomies can be avoided.


Options:
A: Before CT scanning

Inclusion Criteria:

* Clinical suspicion of appendicitis
* Age more than 18 years

Exclusion Criteria:

* Clinical signs of generalized peritonitis
* Previous take of antibiotics within the 5 days preceding the presentation
* Allergy or intolerance to lactamases and/or clavulanate potassium
* Corticosteroid or anticoagulant therapy
* Patient with a known inflammatory bowel disease (Crohn's disease or ulcerative colitis)
* Pregnant women
* Patient with iode allergy
* Renal insufficiency (creatinine \> 200 )

CT scanning:

Inclusion Criteria:

* Appendix diameter \> 6 mm

Exclusion Criteria:

* Appendix non visualised
* Signs of localized peritonitis:

  * extradigestive gas
  * fluid collection around the appendix
  * generalized intraperitoneal fluid
B: Inclusion Criteria:

* Suspected of having acute appendicitis
* Referred for abdomen CT from Emergency Department

Exclusion Criteria:

* Body mass index \< 18.5 kg/m2 (ultrasonography is favored)
* Intravenous contrast-enhancement is contraindicated
C: Inclusion Criteria:

* Age range from 18 to 60 years
* CT scan diagnosed uncomplicated acute appendicitis

Exclusion Criteria:

* Age under 18 years or age over 60 years
* Pregnancy or breast-feeding
* Allergy to contrast media or iodine
* Renal insufficiency
* metformin medication (DM)
* Peritonitis (a perforated appendix)
* Lack of co-operation (unable to give consent)
* A severe other medical condition
* CT-scan: other diagnosis, fecal lithiasis in appendix, perforation, abscess, suspicion of a tumour
D: Inclusion Criteria:

* Emergency department visit with suspected symptoms and signs of acute appendicitis
* Intravenous contrast-enhanced computed tomography examination requested due to suspicion of appendicitis
* Willing to provide telephone or cell phone numbers for follow-up
* Signed informed consent provided prior to study entry

Exclusion Criteria:

* Prior cross-sectional imaging tests to evaluate the presenting symptoms and signs
* Prior history of surgical removal of the appendix

Answer: C