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[Conservative treatment of post-appendectomy abscesses]
C Gutiérrez San-Román1, A Marco Macian, J Vila Carbo
1Departamento de Cirugía Pediátrica H, Infaltil La Fe.
Insights
Antibiotic therapy can effectively treat post-appendectomy intra-abdominal abscesses in children. This approach offers a viable alternative to surgical drainage for some patients, improving outcomes and reducing intervention needs.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Abdominal Imaging
Context:
- Appendectomy is a common surgical procedure in children.
- Intra-abdominal abscesses are a potential complication following appendectomy.
- Current standard treatment involves surgical drainage.
Purpose:
- To evaluate the efficacy of antibiotic therapy as an alternative to surgical drainage for post-appendectomy intra-abdominal abscesses in pediatric patients.
- To assess clinical and ultrasonographic (US) outcomes in children treated with antibiotics.
Summary:
- A prospective study of 626 pediatric patients undergoing appendectomy was conducted.
- 1.4% of patients developed postoperative intra-abdominal abscesses and were treated with metronidazole and amikacin.
- Of nine abscesses, four resolved with antibiotics alone, and three were managed with percutaneous drainage guided by US, demonstrating successful non-surgical interventions.
Impact:
- Antibiotic therapy presents a promising, less invasive alternative for managing select post-appendectomy intra-abdominal abscesses in children.
- This approach may reduce the need for repeat surgical interventions.
- Ultrasonography is crucial for monitoring treatment response and guiding percutaneous drainage.
Abstract:
The standard form of treatment for an abscess in the abdominal cavity is surgical drainage. We present a prospective study of 626 patients under the age of ten who underwent appendectomy. The antibiotic prophylaxis consists of cefoxitin and ampicillin. Postoperative intra-abdominal abscess were found in 1.4% of the patients who were then treated with antibiotics (metronidazole plus amicacin). Following this course of treatment, of the nine abscess, 4 required no surgical drainage, and progressed favourably as shown by the clinical controls and ultrasonography (US). In 3 patients, percutaneous drainage was performed and controlled by US. This paper shows that antibiotic therapy is a useful alternative in the treatment of postappendectomy intraabdominal abscess.