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Initial nonoperative management for periappendiceal abscess.

D Oliak1, D Yamini, V M Udani

  • 1Department of Surgery, Harbor-UCLA Medical Center, 1000 West Carson Street, Torrance, CA 90509, USA.

Diseases of the Colon and Rectum
|August 10, 2001
PubMed
Summary

Initial nonoperative management for periappendiceal abscess is safe and effective, leading to fewer complications. However, patients may face a higher risk of recurrent appendicitis.

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Clinical Outcomes

Background:

  • Appendicitis is a common surgical emergency.
  • Periappendiceal abscess is a serious complication of appendicitis.
  • Management strategies include operative and nonoperative approaches.

Purpose of the Study:

  • To compare initial operative versus nonoperative management for periappendiceal abscess.
  • To evaluate the safety and efficacy of nonoperative treatment.
  • To assess complication rates and recurrence in patients with periappendiceal abscess.

Main Methods:

  • Retrospective review of 155 patients with periappendiceal abscess.
  • Patients treated between 1992 and 1998.
  • Comparison of initial nonoperative (88 patients) versus operative (67 patients) management.

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Main Results:

  • No significant differences in length of stay, normalization of white blood cell count, temperature, or diet tolerance between groups.
  • Nonoperative management had a significantly lower complication rate (17% vs. 36%).
  • Initial nonoperative management showed a 5.8% failure rate and an 8% appendicitis recurrence rate.

Conclusions:

  • Initial nonoperative management of periappendiceal abscess is safe and effective.
  • Nonoperative approach reduces complication rates.
  • Patients managed nonoperatively have an increased risk of recurrent appendicitis.