Letter to the Editor
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2025; 13(28): 109664
Published online Oct 6, 2025. doi: 10.12998/wjcc.v13.i28.109664
Appendicolith in non-operative management of acute appendicitis: Implications for recurrence and future directions
Ju Tian
Ju Tian, Department of Burns and Plastic Surgery, Zhongshan City People’s Hospital, Zhongshan 528400, Guangdong Province, China
Author contributions: Tian J conceptualized and designed the overarching framework and structure of the manuscript. In addition, Tian J actively participated in drafting and revising the content, creating the illustrations, and conducting a comprehensive review of the pertinent literature.
Conflict-of-interest statement: Dr. Tian has nothing to disclose for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ju Tian, Department of Burns and Plastic Surgery, Zhongshan City People’s Hospital, No. 2 Sunwen East Road, Zhongshan 528400, Guangdong Province, China. tian-ju@163.com
Received: May 18, 2025
Revised: June 4, 2025
Accepted: July 17, 2025
Published online: October 6, 2025
Processing time: 81 Days and 23.4 Hours
Core Tip

Core Tip: Kupietzky et al’s study challenges traditional paradigms by demonstrating that appendicoliths alone do not independently elevate long-term recurrence risks in uncomplicated acute appendicitis, thereby reframing nonoperative management as a viable option for low-risk patients. Instead, clinical decisions should prioritize individualized risk assessments—incorporating symptom severity, imaging markers (e.g., appendix diameter > 1 cm), and shared decision-making with patients—while emphasizing close surveillance (especially within the initial 6-12 months) to enable timely intervention for recurrences.