Patients who have localized pain without signs and symptoms of local peritonitis and without evidence of systemic infection may be treated on an outpatient basis. Careful follow-up should be arranged with the patient's primary physician. The patient should be begun on a clear liquid diet and advance to low-residue foods as symptoms improve. Patients should be instructed to return if fever develops, if they are unable to tolerate oral intake, or if there is worsening abdominal pain.
If a patient has systemic signs and symptoms of infection, has failed outpatient management, or demonstrates signs of localized peritonitis, hospitalization is necessary. Surgical consultation should be obtained at the time of hospitalization. Urgent surgical consultation is indicated if free perforation is found.
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