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Perforated appendicitis: urgency or interval surgery?

Z-F Liu1, J-C Yu, H-F Hsieh

  • 1Department of Internal Medicine, General Hospital, Taoyuan.

Zentralblatt Fur Chirurgie
|December 22, 2007
PubMed
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Conservative treatment with interval appendectomy (IA) for ruptured appendicitis is safe and effective. However, patients may experience longer recovery and hospital stays, making it not cost-saving.

Area of Science:

  • Surgery
  • Gastroenterology
  • Infectious Diseases

Background:

  • Perforated appendicitis with localized abscess or phlegmon presents a clinical challenge.
  • Conservative management strategies are continuously being evaluated for efficacy and patient outcomes.

Purpose of the Study:

  • To evaluate the outcomes of conservative treatment with interval appendectomy (IA) for ruptured appendicitis with localized abscess or phlegmon.

Main Methods:

  • A retrospective study comparing 104 patients who underwent immediate appendectomy (Group A) with 17 patients treated with antibiotics and IA (Group B).
  • Clinical characteristics, laboratory data, operative details, complications, and hospitalization costs were recorded and analyzed.

Main Results:

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  • No significant differences were observed in sex, age, WBC count, body temperature, operation time, post-operative length of stay, or complication rates between the groups.
  • Patients in Group B (antibiotics with IA) had a significantly longer length of stay from diagnosis establishment compared to Group A.

    • Conclusions:

    • Conservative treatment with IA is a safe and effective approach for perforated appendicitis with localized abscess/phlegmon.
    • While safe, IA may lead to prolonged recovery and hospital stays, negating cost-saving benefits.