Russian Journal of Pediatric SurgeryRussian Journal of Pediatric SurgeryДетская хирургия1560-95102412-0677Eco-Vector90710.17816/ps907DQSEOCPractice GuidelinesКлинические рекомендацииReview ArticleAcute appendicitis and peritonitis in children. Clinical guidelinesОстрый аппендицит и перитонит у детей. Клинические рекомендацииhttps://orcid.org/0000-0001-9418-44187894-8369KarasevaOlga V.КарасеваОльга Витальевна
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук

karaseva.o@list.ruhttps://orcid.org/0000-0001-6814-88943127-9804AxelrovMichael A.АксельровМихаил Александрович
Russian Federation

MD, Dr. Sci. (Medicine), Assistant Professor

д-р мед. наук, доцент

akselerov@mail.ruhttps://orcid.org/0000-0002-8446-830X6025-8991BairovVladimir G.БаировВладимир Гиреевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

v-bairov@mail.ruhttps://orcid.org/0000-0001-5857-22965365-0960BarovaNatusya K.БароваНатуся Каплановна
Russian Federation

MD, Cand. Sci. (Medicine), Assistant Professor

канд. мед. наук, доцент

nbarova@yandex.ruhttps://orcid.org/0000-0002-7069-72676604-3686BarskayaMargarita A.БарскаяМаргарита Александровна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

barskaya63@yandex.ruhttps://orcid.org/0009-0001-7508-85246230-8980BryantsevAlexander V.БрянцевАлександр Владимирович
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

alex_br@doctor-roshal.ruhttps://orcid.org/0000-0001-5982-54946716-9241GolikovDenis E.ГоликовДенис Евгеньевич
Russian Federation

MD

GolikovDE@zdrav.mos.ruhttps://orcid.org/0000-0002-5512-98944034-4303GolovanevMaхim A.ГолованевМаксим Алексеевич
Russian Federation

MD, Cand. Sci. (Medicine), Assistant Professor

канд. мед. наук, доцент

aesculap2001@mail.ruhttps://orcid.org/0000-0003-1746-84467444-8233GorelikAlexander L.ГореликАлександр Львович
Russian Federation

MD

GorelikAL1@zdrav.mos.ruhttps://orcid.org/0000-0003-1836-979X9056-7448ZhuriloIvan P.ЖурилоИван Петрович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

zhipsurg@mail.ruhttps://orcid.org/0000-0002-1940-13958779-8960MorozovDmitry A.МорозовДмитрий Анатольевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

damorozov@list.ruhttps://orcid.org/0000-0003-2032-921X4354-4462NalivkinAlexander E.НаливкинАлександр Евгеньевич
Russian Federation

MD, Dr. Sci. (Medicine), Assistant Professor

д-р мед. наук, доцент

surgnal@yandex.ruhttps://orcid.org/0000-0002-9077-69904340-8700PoddoubnyiIgor V.ПоддубныйИгорь Витальевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

Igorpoddoubnyi@yandex.ruhttps://orcid.org/0000-0002-9497-40703600-4701RazumovskiyAleksander Yu.РазумовскийАлександр Юрьевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor, corresponding member of the Russian Academy of Sciences

д-р мед. наук, профессор, чл.-корр. РАН

1595105@mail.ruhttps://orcid.org/0000-0002-0126-31907684-9637SvarichVyacheslav G.СваричВячеслав Гаврилович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

svarich61@mail.ruhttps://orcid.org/0000-0002-8646-189X6810-0334SmirnovAleksey N.СмирновАлексей Николаевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

smirnov-dgkb13@yandex.ruhttps://orcid.org/0000-0003-3831-768X9674-1049SokolovYurij Yu.СоколовЮрий Юрьевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

sokolov-surg@yandex.ruhttps://orcid.org/0000-0002-6940-45355237-8098TimofeevaAnna V.ТимофееваАнна Вячеславовна
Russian Federation
TimofeevaAV4@zdrav.mos.ruhttps://orcid.org/0000-0001-9050-36297466-8731TsapNatalia A.ЦапНаталья Александровна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

tsapna-ekat@rambler.ruClinical and Research Institute of Emergency Pediatric Surgery and Trauma―Dr. Roshal’s ClinicНаучно-исследовательский институт неотложной детской хирургии и травматологии ― Клиника доктора РошаляTyumen State Medical UniversityТюменский государственный медицинский университетNational Medical Research Center named after V.A. AlmazovНациональный медицинский исследовательский центр имени В.А. АлмазоваKuban State Medical UniversityКубанский государственный медицинский университетChildren’s Regional Clinical Hospital No. 1, KrasnodarДетская краевая клиническая больница № 1, КраснодарSamara State Medical UniversityСамарский государственный медицинский университетThe Russian National Research Medical University named after N.I. PirogovРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаOrel State UniversityОрловский государственный университет имени И.С. ТургеневаMoscow Regional Research and Clinical InstituteМосковский областной научно-исследовательский клинический институт имени М.Ф. ВладимирскогоRussian University of MedicineРоссийский университет медициныSaint-Petersburg State Pediatric Medical UniversityСанкт-Петербургский государственный педиатрический медицинский университетRussian Medical Academy of Continuous Professional EducationРоссийская медицинская академия непрерывного профессионального образованияUral State Medical UniversityУральский государственный медицинский университет110120263003202630135642212202524122025Copyright ©; 2026,Copyright ©; 2026, Эко-вектор2026Эко-векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://jps-nmp.ru/jour/article/view/907

A new edition of clinical guidelines, developed by leading specialists of the Russian Association of Pediatric Surgeons, contains updated information on the treatment and diagnostics of the disease in compliance with the latest advances in emergency abdominal surgery. To diagnose such patients in a specialized surgical hospital, it is recommended to make ultrasound examination of the abdominal organs, as a basic mandatory noninvasive diagnostic technique, and to arrange dynamic follow-up for up to 12 hours in case of a doubtful diagnosis of acute appendicitis, which may be followed by diagnostic laparoscopy.

The presented edition discusses, in details, classification of acute appendicitis and peritonitis in children, highlights its basic complicated forms: appendicular infiltrate, appendicular peritonitis and periappendicular abscess.

For the first time, the authors present their material on accumulated global experience on the conservative treatment of acute appendicitis in children; they also discuss options on conducting such researches in large scientific centers in Russia after Russian Association of Pediatric Surgeons approval. The issues of preoperative preparation, postoperative management and rehabilitation of patients with severe appendicular peritonitis are discussed as well.

Новая редакция клинических рекомендаций Российской ассоциации детских хирургов (РАДХ) содержит обновлённую информацию по лечению и диагностике заболевания в соответствии с новейшими достижениями в неотложной абдоминальной хирургии. Рекомендации основаны на результатах завершённых отечественных и международных доказательных исследований, включая систематические и рандомизированные клинические исследования.

Для диагностики в условиях специализированного хирургического стационара в качестве основных методов обязательной неинвазивной инструментальной диагностики рекомендованы ультразвуковое исследование органов брюшной полости и динамическое наблюдение при сомнительном диагнозе острого аппендицита длительностью до 12 часов с последующей диагностической лапароскопией.

В представленной редакции подробно рассматриваются вопросы классификации острого аппендицита и перитонита у детей, выделены основные осложнённые формы: аппендикулярный инфильтрат, аппендикулярный перитонит и периаппендикулярный абсцесс.

Впервые представлен материал о накопленном мировом опыте по консервативному лечению острого аппендицита у детей и рассматривается возможность проведения подобных исследований в крупных научных центрах после согласования и одобрения РАДХ. Рассматриваются вопросы предоперационной подготовки, послеоперационного ведения и реабилитации пациентов, перенёсших тяжёлые формы аппендикулярного перитонита.

childrenacute appendicitisappendicular peritonitislaparoscopic appendectomyappendicular infiltrateperiaappendicular abscessdrainagelavageconservative treatmentsurgical treatmentappendectomyдетиострый аппендицитаппендикулярный перитонитлапароскопическая аппендэктомияаппендикулярный инфильтратпериаппендикулярный абсцессдренированиепромываниеконсервативное лечениехирургическое лечениеаппендэктомияKolesov VI. Acute appendicitis. Leningrad: Medgiz; 1959. 290 p. (In Russ.)Schülin S, Schlichting N, Blod C, et al. The intra- and extraluminal appendiceal microbiome in pediatric patients: a comparative study. Medicine (Baltimore). 2017;96(52):e9518. doi: 10.1097/MD.0000000000009518Averyanova YuV, Akinshina AD, Aliev MD, et al. Pediatric surgery: national guidelines. Razumovsky AY, editor. 2nd ed., revised and updated. Moscow: GEOTAR-Media; 2021. 1280 p. (In Russ.) doi: 10.33029/9704-5785-6-PSNR-2021-2-1-1280 EDN: CYXTINLotfollahzadeh S, Lopez RA, Deppen JG. Appendicitis. 2024 Feb 12. In: Stat Pearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; 2025.Bairov GA. Emergency surgery for children: a guide for doctors. Saint Petersburg: Peter Press; 1997. P. 165–188. (In Russ.)Isakov YuF, Stepanov EA, Krasovskaya TV. Abdominal surgery in children. Moscow: Meditsina; 1988. 415 p. (In Russ.)Ashcraft KU, Holder TM. Pediatric surgery. In 3 volumes. Vol. 2. Saint Petersburg: Pit-Tal; 1997. P. 93–97. (In Russ.)Gadiparthi R, Waseem M. Pediatric appendicitis. 2023 Jul 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.Mortell AE, Coyle D. Appendicitis. In: Puri P, editor. Pediatric surgery. Springer, Berlin, Heidelberg; 2021. doi: 10.1007/978-3-662-43559-5_105Loux TJ. Appendicitis. In: Coppola CP, Kennedy AP, editors. Pediatric surgery. Springer, Cham; 2022. doi: 10.1007/978-3-030-96542-6_56Gorter RR, Eker HH, Gorter-Stam MA, et al. Diagnosis and management of acute appendicitis. EAES consensus development conference 2015. Surg Endosc. 2016;30(11):4668–4690. doi: 10.1007/s00464-016-5245-7Anderson JE, Bickler SW, Chang DC, Talamini MA. Examining a common disease with unknown etiology: trends in epidemiology and surgical management of appendicitis in California, 1995–2009. World J Surg. 2012;36(12):2787–2794. doi: 10.1007/s00268-012-1749-zHe R, Lai J, Jiang O, Li J. The incidence and temporal trend of appendicitis in children: an analysis from the Global Burden of Disease Study 2021. J Gastrointest Surg. 2025;29(2):101935. doi: 10.1016/j.gassur.2024.101935Barnes E, Hayes R, Halpin SL, Nasim S. Sensitivity and specificity of surgeons’ intra-operative diagnosis of appendicitis. A systematic review and meta-analysis. Surgeon. 2025;23(2):e63–e70. doi: 10.1016/j.surge.2024.10.006Doletsky SYa, Shchitinin VE, Arapova AV. Complicated appendicitis in children. Leningrad: Meditsina; 1982. 189 p. (In Russ.)Roshal LM, Karaseva OV. To the classification of acute appendicitis and its complications. Russian pediatric journal. 2006;(2):34–37. EDN: RUZQBZKaraseva OV, Utkina KE, Gorelik AL, et al. Appendicular peritonitis in children: an efficient surgical approach and intensive care. Russian Journal of Pediatric Surgery. 2020;24(2):62–70. doi: 10.18821/1560–9510–2020-24-2-62-70 EDN: ENQVKCSokolov YuYu, Korovin SA. Version of the classification acute appendicitis and peritonitis in children. Russian journal of pediatric surgery, anesthesia and intensive care. 2013;3(1):28–31. EDN: PZVTQXDavydovsky IV. General human pathology. 2nd ed., revised and updated. Moscow: Meditsina; 1969. 612 p. (In Russ.)Abrikosov AI. Acute appendicitis. In book: Guide to pathological anatomy. Part 2. Moscow: Meditsina; 1957. P. 108–446. (In Russ.)Di Saverio S, Podda M, de Simone B, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg. 2020;15(1):27. doi: 10.1186/s13017-020-00306-3Gelfrand BR, Filimonov MI, Burnevich SZ. Abdominal sepsis. Russkii meditsinskii zhurnal. 1998;(11):3. (In Russ.)Vrancx S, van de Sande J, Vanclooster P, et al. Burkitt lymphoma mimicking an acute appendicitis in a 17-year-old boy: a case report. Acta Chir Belg. 2015;115(4):306–309. doi: 10.1080/00015458.2015.11681117Paran M, Dreznik Y, Totah M, et al. Diagnostic challenges of acute appendicitis in preschool children: a comprehensive case-control study. J Paediatr Child Health. 2025;61(3):369–375. doi: 10.1111/jpc.16748Andersson M, Andersson R.E. The appendicitis inflammatory response score: a tool for the diagnosis of acute appendicitis that outperforms the Alvarado score. World J Surg. 2008;32(8):1843–1849. doi: 10.1007/s00268-008-9649-y Erratum in: World J Surg. 2012;36(9):2269–2270.Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15(5):557–564.Samuel M. Pediatric appendicitis score. J Pediatr Surg. 2002;37(6):877–881. doi: 10.1053/jpsu.2002.32893Börner N, Kappenberger AS, Weber S, et al. The acute abdomen: structured diagnosis and treatment. Dtsch Arztebl Int. 2025;(Forthcoming):arztebl.m2025.0019. doi: 10.3238/arztebl.m2025.0019Kosloske AM, Love CL, Rohrer JE, et al. The diagnosis of appendicitis in children: outcomes of a strategy based on pediatric surgical evaluation. Pediatrics. 2004;113(1 Pt 1):29–34. doi: 10.1542/peds.113.1.29Tan QL, Tang Q, Chen XQ, et al. Acute abdominal pain as the initial presenting symptom of pediatric Burkitt lymphoma: a case report and literature review. Medicine (Baltimore). 2025;104(8):e41600. doi: 10.1097/MD.0000000000041600Tang G, Zhang L, Xia L, et al. Preoperative in-hospital delay increases postoperative morbidity and mortality in patients with acute appendicitis: a meta-analysis. Int J Surg. 2025;111(1):1275–1284. doi: 10.1097/JS9.0000000000001938Cameron DB, Williams R, Geng Y, et al. Time to appendectomy for acute appendicitis: a systematic review. J Pediatric Surg. 2018;53(3):396–405. doi: 10.1016/j.jpedsurg.2017.11.042Aizenberg VL, Amcheslavsky VG, Bykov MV, et al. Emergency care and intensive care in pediatrics. Lazarev VV, editor. Moscow: MEDpress-inform; 2014. 568 p. (In Russ.)Stepanenko SM, Afukov II, Zilbert EV, et al. Anesthesiology, intensive care and intensive care in children: textbook. Stepanenko SM, editor. Moscow: GEOTAR-Media; 2016. 240 p. (In Russ.) EDN: WBYKPRAl-Ajerami Y. Sensitivity and specificity of ultrasound in the diagnosis of acute appendicitis. East Mediterr Health J. 2012;18(1):66–69. doi: 10.26719/2012.18.1.66El-Gohary Y, Molina M, Chang J, et al. The use of computed tomography versus clinical acumen in diagnosing appendicitis in children: a two-institution international study. J Pediatr Surg. 2021;56(8):1356–1361. doi: 10.1016/j.jpedsurg.2020.09.061Badlis M, Amari K, Alkheshi M, et al. Ultrasound and computed tomography in differentiating between simple and complicated appendicitis in pediatric patients. Pediatr Surg Int. 2024;40(1):299. doi: 10.1007/s00383-024-05880-0Lu K, Zhong F, Miao J, et al. Assessment of diagnostic value of ultrasound and multi-slice spiral computed tomography in acute appendicitis: a retrospective study. Abdom Radiol (NY). 2025;50(3):1117–1122. doi: 10.1007/s00261-024-04584-2Benabbas R, Hanna M, Shah J, Sinert R. Diagnostic accuracy of history, physical examination, laboratory tests, and point-of-care ultrasound for pediatric acute appendicitis in the emergency department: a systematic review and meta-analysis. Acad Emerg Med. 2017;24(5):523–551. doi: 10.1111/acem.13181Doria AS. Optimizing the role of imaging in appendicitis. Pediatr Radiol. 2009;39(Suppl 2):144–148. doi: 10.1007/s00247-008-1105-5Şimşek O, Şirolu S, Özkan Irmak Y, et al. Comparative study of imaging features in uncomplicated and complicated acute appendicitis. Ulus Travma Acil Cerrahi Derg. 2024;30(10):722–728. doi: 10.14744/tjtes.2024.50363Barger RL, Nandalur KR. Diagnostic performance of magnetic resonance imaging in the detection of appendicitis in adults: a meta-analysis. Acad Radiol. 2010;17(10):1211–1216. doi: 10.1016/j.acra.2010.05.003D’Souza N, Hicks G, Beable R, et al. Magnetic resonance imaging (MRI) for diagnosis of acute appendicitis. Cochrane Database Syst Rev. 2021;12(12):CD012028. doi: 10.1002/14651858.CD012028.pub2Finkelson EI, Granikov OD, Petlakh VI, Blinnikov OI. Diagnostic and therapeutic laparoscopy in pediatric emergency surgery. In: Abstracts of the All-Russian scientific and practical conference of surgeons Endoscopy in emergency surgery of abdominal organs. Saratov; 1980. P. 96–99. (In Russ.)Granikov OD, Petlakh VI. Therapeutic and diagnostic laparoscopy for primary peritonitis in children. In: Scientific papers of the Central Institute of Advanced Medical Training: the collection of articles. Moscow; 1982. P. 71. (In Russ.)Roshal LM, Grannikov OD, Petlakh VI. Therapeutic laparoscopy in pediatric emergency surgery. Pirogov Russian journal of surgery. 1985;61(10):63–66. (In Russ.)Dyakonova EYu, Razumovsky AYu, Alkhasov AB, et al. Laparoscopic surgeries in pediatric abdominal surgical emergencies. Pediatric pharmacology. 2018;15(1):9–19. doi: 10.15690/pf.v15i1.1839 EDN: YQDFWSDronov AF, Poddubny IV, Kotlobovsky VI. Endoscopic surgery in children. Isakov YuF, Dronov AF, editors. Moscow: GEOTAR-Media; 2002. 440 p. (In Russ.)Gaitán HG, Reveiz L, Farquhar C, Elias VM. Laparoscopy for the management of acute lower abdominal pain in women of childbearing age. Cochrane Database Syst Rev. 2014;2014(5):CD007683. doi: 10.1002/14651858.CD007683.pub3Zhou S, Cheng Y, Cheng N, et al. Early versus delayed appendicectomy for appendiceal phlegmon or abscess. Cochrane Database Syst Rev. 2024;5(5):CD011670. doi: 10.1002/14651858.CD011670.pub3Simillis C, Symeonides P, Shorthouse AJ, Tekkis PP. A meta-analysis comparing conservative treatment versus acute appendectomy for complicated appendicitis (abscess or phlegmon). Surgery. 2010;147(6):818–829. doi: 10.1016/j.surg.2009.11.013Andersson RE, Petzold MG. Nonsurgical treatment of appendiceal abscess or phlegmon: a systematic review and meta-analysis. Ann Surg. 2007;246(5):741–748. doi: 10.1097/SLA.0b013e31811f3f9fDarwazeh G, Cunningham SC, Kowdley GC. A systematic review of perforated appendicitis and phlegmon: interval appendectomy or wait-and-see? Am Surg. 2016;82(1):11–15.Vargas HI, Averbook A, Stamos MJ. Appendiceal mass: conservative therapy followed by interval laparoscopic appendectomy. Am Surg. 1994;60(10):753–758.Zhang HL, Bai YZ, Zhou X, Wang WL. Nonoperative management of appendiceal phlegmon or abscess with an appendicolith in children. J Gastrointest Surg. 2013;17(4):766–770. doi: 10.1007/s11605-013-2143-3Razumovsky AY, Dronov AF, Smirnov AN, Golovanev MA. Acute appendicitis in children. Russian journal of pediatric surgery, anesthesia and intensive care. 2013;3(4):125–132. EDN: RAQFXOMonti M, Agamennone M, Wong MC, et al. Role of conservative management of acute appendicitis in pediatric age: a monocentric experience. Updates Surg. 2025;77(4):1059–1066. doi: 10.1007/s13304-025-02136-xDoleman B, Fonnes S, Lund JN, et al. Appendectomy versus antibiotic treatment for acute appendicitis. Cochrane Database Syst Rev. 2024;4(4):CD015038. doi: 10.1002/14651858.CD015038.pub2Kaminsky MN. Conservative treatment of acute appendicitis, 10 years late. Far Eastern medical journal. 2023;(1):12–21. doi: 10.35177/1994-5191-2023-1-2 EDN: FCBCSXWilms IM, de Hoog DE, de Visser DC, Janzing HM. Appendectomy versus antibiotic treatment for acute appendicitis. Cochrane Database Syst Rev. 2011;(11):CD008359. doi: 10.1002/14651858.CD008359.pub2 Update in: Cochrane Database Syst Rev. 2020;10(10):CD008359. doi: 10.1002/14651858.CD008359.pub3Georgiou R, Eaton S, Stanton MP, et al. Efficacy and safety of nonoperative treatment for acute appendicitis: a meta-analysis. Pediatrics. 2017;139(3):e20163003. doi: 10.1542/peds.2016-3003Andersen BR, Kallehave FL, Andersen HK. Antibiotics versus placebo for prevention of postoperative infection after appendicectomy. Cochrane Database Syst Rev. 2005;2005(3):CD001439. doi: 10.1002/14651858.CD001439.pub2Tarchini G, Liau KH, Solomkin JS. Antimicrobial stewardship in surgery: challenges and opportunities. Clin Infect Dis. 2017;64(suppl 2):S112–S114. doi: 10.1093/cid/cix087Wakeman D, Livingston MH, Levatino E, et al. Reduction of surgical site infections in pediatric patients with complicated appendicitis: utilization of antibiotic stewardship principles and quality improvement methodology. J Pediatr Surg. 2022;57(1):63–73. doi: 10.1016/j.jpedsurg.2021.09.031Laroche S, Voron T, Raimbert P, et al. Postoperative antibiotics after appendectomy for acute appendicitis: no evidence of benefit, even with intra-abdominal fluid. Ann Surg. 2025. doi: 10.1097/SLA.0000000000006693 EDN: UZKBHAGelfand BR, Burnevich SZ, Gelfand EB, Popov TV. Antibacterial therapy of intraabdominal surgical infections. Pharmateca. 2003;(1):68–73.De Wijkerslooth EM, Boerma EG, van Rossem CC, et al.; APPIC Study Group. Two days versus five days of postoperative antibiotics for complex appendicitis: cost analysis of a randomized, noninferiority trial. Ann Surg. 2024;279(5):885–890. doi: 10.1097/SLA.0000000000006089Horn CB, Coleoglou Centeno AA, Guerra JJ, et al. Drain failure in intraabdominal abscesses associated with appendicitis. Surg Infect (Larchmt). 2018;19(3):321–325. doi: 10.1089/sur.2017.224Gavriilidis P, de’ Angelis N, Katsanos K, et al. Acute appendicectomy or conservative treatment for complicated appendicitis (phlegmon or abscess)? A systematic review by updated traditional and cumulative meta-analysis. J Clin Med Res. 2019;11(1):56–64. doi: 10.14740/jocmr3672Cheng Y, Xiong X, Lu J, et al. Early versus delayed appendicectomy for appendiceal phlegmon or abscess. Cochrane Database Syst Rev. 2017;6(6):CD011670. doi: 10.1002/14651858.CD011670.pub2Luo CC, Cheng KF, Huang CS, et al. Therapeutic effectiveness of percutaneous drainage and factors for performing an interval appendectomy in pediatric appendiceal abscess. BMC Surg. 2016;16(1):72. doi: 10.1186/s12893-016-0188-4Karasyova OV, Kapustin VA, Bryantsev AV. Laparoscopic operations in children with appendicular peritonitis complicated by abscess formation. Russian Journal of Pediatric Surgery. 2005;(3):25–29. EDN: HSYVNLCoccolini F, Roberts D, Ansaloni L, et al. The open abdomen in trauma and non-trauma patients: WSES guidelines. World J Emerg Surg. 2018;13:7. doi: 10.1186/s13017-018-0167-4Yu MC, Feng Y, Wang W, et al. Is laparoscopic appendectomy feasible for complicated appendicitis? A systematic review and meta-analysis. Int J Surg. 2017;40:187–197. doi: 10.1016/j.ijsu.2017.03.022Cirocchi R, Cianci MC, Amato L, et al. Laparoscopic appendectomy with single port vs conventional access: systematic review and meta-analysis of randomized clinical trials. Surg Endosc. 2024;38(4):1667–1684. doi: 10.1007/s00464-023-10659-w Erratum in: Surg Endosc. 2024;38(4):2305. doi: 10.1007/s00464-024-10750-wZhang S, Du T, Jiang X, et al. Laparoscopic appendectomy in children with perforated appendicitis: a meta-analysis. Surg Laparosc Endosc Percutan Tech. 2017;27(4):262–266. doi: 10.1097/SLE.0000000000000411Yang HR, Wang YC, Chung PK, et al. Laparoscopic appendectomy using the LigaSure Vessel Sealing System. J Laparoendosc Adv Surg Tech A. 2005;15(4):353–356. doi: 10.1089/lap.2005.15.353Sucullu I, Filiz AI, Kurt Y, et al. The effects of LigaSure on the laparoscopic management of acute appendicitis: LigaSure assisted laparoscopic appendectomy. Surg Laparosc Endosc Percutan Tech. 2009;19(4):333–335. doi: 10.1097/SLE.0b013e3181a99288Diamantis T, Kontos M, Arvelakis A, et al. Comparison of monopolar electrocoagulation, bipolar electrocoagulation, ultracision, and ligasure. Surg Today. 2006;36(10):908–913. doi: 10.1007/s00595-006-3254-1Pogorelić Z, Katić J, Mrklić I, et al. Lateral thermal damage of mesoappendix and appendiceal base during laparoscopic appendectomy in children: comparison of the harmonic scalpel (Ultracision), bipolar coagulation (LigaSure), and thermal fusion technology (MiSeal). J Surg Res. 2017;212:101–107. doi: 10.1016/j.jss.2017.01.014Wright GP, Mitchell EJ, McClure AM, et al. Comparison of stapling techniques and management of the mesoappendix in laparoscopic appendectomy. Surg Laparosc Endosc Percutan Tech. 2015;25(1):e11–15. doi: 10.1097/SLE.0000000000000040Swank HA, van Rossem CC, van Geloven AA, et al. Endostapler or endoloops for securing the appendiceal stump in laparoscopic appendectomy: a retrospective cohort study. Surg Endosc. 2014;28(2):576–583. doi: 10.1007/s00464-013-3207-xVan Rossem CC, van Geloven AA, et al.; snapshot appendicitis collaborative study group. Endoloops or endostapler use in laparoscopic appendectomy for acute uncomplicated and complicated appendicitis: no difference in infectious complications. Surg Endosc. 2017;31(1):178–184. doi: 10.1007/s00464-016-4951-5Ceresoli M, Tamini N, Gianotti L, et al. Are endoscopic loop ties safe even in complicated acute appendicitis? A systematic review and meta-analysis. Int J Surg. 2019;68:40–47. doi: 10.1016/j.ijsu.2019.06.011You KS, Kim DH, Yun HY, et al. The value of a laparoscopic interval appendectomy for treatment of a periappendiceal abscess: experience of a single medical center. Surg Laparosc Endosc Percutan Tech. 2012;22(2):127–130. doi: 10.1097/SLE.0b013e318244ea16Peter SD. Reply to letter: “irrigation versus suction alone during laparoscopic appendectomy for perforated appendicitis”. Ann Surg. 2015;261(4):e98. doi: 10.1097/SLA.0000000000000449Bi LW, Yan BL, Yang QY, Cui HL. Peritoneal irrigation vs suction alone during pediatric appendectomy for perforated appendicitis: a meta-analysis. Medicine (Baltimore). 2019;98(50):e18047. doi: 10.1097/MD.0000000000018047Zhou Q, Meng W, Ren Y, et al. Effectiveness of intraoperative peritoneal lavage with saline in patient with intra-abdominal infections: a systematic review and meta-analysis. World J Emerg Surg. 2023;18(1):24. doi: 10.1186/s13017-023-00496-6Krinock DJ, Stephenson K, Irby D, et al. Intra-peritoneal povidone-iodine irrigation decreases abscesses in a perforated appendicitis murine model. J Pediatr Surg. 2025;60(3):162081. doi: 10.1016/j.jpedsurg.2024.162081Li Z, Zhao L, Cheng Y, et al. Abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis. Cochrane Database Syst Rev. 2018;5(5):CD010168. doi: 10.1002/14651858.CD010168.pub3 Update in: Cochrane Database Syst Rev. 2021;8:CD010168. doi: 10.1002/14651858.CD010168.pub4Neville JJ, Aldeiri B. Drain placement in paediatric complicated appendicitis: a systematic review and meta-analysis. Pediatr Surg Int. 2023;39(1):171. doi: 10.1007/s00383-023-05457-3Schlottmann F, Reino R, Sadava EE, et al. Could an abdominal drainage be avoided in complicated acute appendicitis? Lessons learned after 1300 laparoscopic appendectomies. Int J Surg. 2016;36(Pt A):40–43. doi: 10.1016/j.ijsu.2016.10.013Alabbad J, Alhamly H, Alrubaiaan A, et al. The utility of intraperitoneal drain placement after laparoscopic appendectomy for perforated appendicitis in postoperative intraperitoneal abscess prevention. Surg Endosc. 2024;38(7):3571–3577. doi: 10.1007/s00464-024-10869-wWu H, Liao B, Cao T, et al. Advantages comparison of peritoneal drainage versus no drainage after laparoscopic appendectomy for complicated appendicitis: a meta-analysis. BMC Gastroenterol. 2024;24(1):411. doi: 10.1186/s12876-024-03500-8AlRamahi RW, Woerner A, Rizvi H, Monroe EJ. Complicated appendicitis in the pediatric patient: interventional perspectives. Clin Imaging. 2025;118:110371. doi: 10.1016/j.clinimag.2024.110371Aneiros Castro B, Cano I, García A, et al. Abdominal drainage after laparoscopic appendectomy in children: an endless controversy? Scand J Surg. 2018;107(3):197–200. doi: 10.1177/1457496918766696Swarich VG, Perevozchikov EG, Kagantsov IM. Unligature method of laparoscopic appendectomy in children. Russian journal of pediatric surgery, anesthesia and intensive care. 2020;10(1):53–58. doi: 10.17816/psaic583 EDN: EEQDQRBairov GA, Parnes DI. Treatment of intestinal paresis in childhood. Grekov’s bulletin of Surgery. 1976;117(7):73–78. EDN: ZQMNHVEshov DN, Kodirov AR, Saidov ER, Fayzulloev IK. Prolonged peridural analgesia in the postoperative period in children with diffuse peritonitis. Zdravookhranenie Tadzhikistana. 2015;(S1):162–164. (In Russ.) EDN: UJWSZCStepanov AV, Khromova YuV, Cheptsov FR, Bazarkhandaev AR. Epidural anesthesia in severe forms of peritonitis. In: Modern trends and ways of development of anesthesiology in the Russian Federation: Proceedings of the All-Russian Congress, Moscow, November 07-10, 2006. Moscow: Russian Medical Academy of Postgraduate Education; 2006. P. 85. (In Russ.) EDN: THCMEFAkalaev RN, Borisova EM, Evdokimov EA, et al. Hyperbaric medicine: the history of formation and path of development. The bulletin of emergency medicine. 2014;(1):85–87. (In Russ.)Aitaliev ASh, Momynkulov AO, Kryuchkov VA, et al. Hyperbaric oxygenation in the treatment of peritonitis. Medical news of North Caucasus. 2009;(1):60b–61. (In Russ.) EDN: MWNWWDWeimann A, Braga M, Carli F, et al. ESPEN practical guideline: clinical nutrition in surgery. Clin Nutr. 2021;40(7):4745–4761. doi: 10.1016/j.clnu.2021.03.031Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48–79. doi: 10.1016/j.clnu.2018.08.037Singer P, Blaser AR, Berger MM, et al. ESPEN practical and partially revised guideline: clinical nutrition in the intensive care unit. Clin Nutr. 2023;42(9):1671–1689. doi: 10.1016/j.clnu.2023.07.011Mihatsch W, Shamir R, van Goudoever JB, et al.; ESPEN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral Nutrition. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: guideline development process for the updated guidelines. Clin Nutr. 2018;37(6 Pt B):2306–2308. doi: 10.1016/j.clnu.2018.06.943Galperin YuM. Paresis, paralysis and functional intestinal obstruction. Moscow; 1975. 219 p. (In Russ.)Bagayev VG, Roshal LM, Ostreikov IF, et al. The enteral feeding within the treatment of appendicular peritonitis in children. Russian Journal of Anesthesiology and Reanimatology. 2003;(3):57. EDN: OKBKVXIlyina IV. Medical rehabilitation: textbook. 2nd ed., revised and updated. Moscow: Yurait; 2024. 333 p. (In Russ.) EDN: QOOAKH