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Risk factors for post-appendicectomy intra-abdominal abscess.

R I Reid1, B R Dobbs, F A Frizelle

  • 1Department of Surgery, Christchurch School of Medicine and Hospital, New Zealand.

The Australian and New Zealand Journal of Surgery
|June 3, 1999
PubMed
Summary

Post-appendicectomy intra-abdominal abscesses occurred in 1.4% of cases. The primary risk factor identified was gangrenous or perforated appendicitis, particularly in open appendicectomy procedures.

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Area of Science:

  • Surgical outcomes and complications
  • Gastrointestinal surgery
  • Infectious disease in surgery

Background:

  • Appendicectomy is a common emergency surgery with typically low complication rates.
  • Post-appendicectomy intra-abdominal abscesses are a significant concern for patients and surgeons.
  • This study investigates the incidence and risk factors for these abscesses.

Purpose of the Study:

  • To determine the incidence of post-appendicectomy intra-abdominal abscess formation.
  • To identify risk factors associated with the development of intra-abdominal abscesses after appendicectomy.
  • To compare complication rates between open and laparoscopic appendicectomy techniques.

Main Methods:

  • Retrospective review of appendicectomies performed at Christchurch Hospital in 1995.

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  • Data collected included surgical approach, histological diagnosis, and postoperative complications.
  • Analysis of 417 appendicectomy cases (331 open, 66 laparoscopic, 20 laparotomy).

    • Main Results:

    • An overall incidence of 1.4% for post-appendicectomy intra-abdominal abscesses was observed.
    • All six abscesses occurred in the open appendicectomy group, associated with perforated or gangrenous appendicitis (P < 0.001).
    • No abscesses were reported after laparoscopic appendicectomy; however, two iatrogenic perforations occurred.

    Conclusions:

    • The incidence of intra-abdominal abscess after appendicectomy is 1.4%.
    • Gangrenous or perforated appendicitis is the sole identified risk factor for post-appendicectomy intra-abdominal abscess.
    • Laparoscopic appendicectomy showed no cases of intra-abdominal abscess in this study.