Endoscopic retrograde appendicitis therapy: a starting point for a change of perspective in treating acute appendicitis (and beyond)

As a surgeon who grew up with the dogma that every acute appendicitis demands a surgical treatment with appendectomy, I could never have imagined myself re-evaluating the role of nonoperative treatment with antibiotics and other preserving strategies for acute appendicitis. However, as the great philosopher Arthur Schopenhauer said “There are three steps in the revelation of any truth: in the first, it is ridiculed; in the second, resisted; in the third, it is considered self-evident.” After passionately investigating the role of antibiotics as the sole treatment for uncomplicated acute appendicitis, I confess I am currently in the second step in the revelation of the truth, but very close to the third.