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Perforated appendix with abscess: Immediate or interval appendectomy? Some examples to explain our choice

Edoardo Guida1, Federica Pederiva1, Massimo Di Grazia2

  • 1Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.

International Journal of Surgery Case Reports
|May 19, 2015
PubMed

Insights

For perforated appendicitis with abscess, conservative antibiotic therapy followed by interval appendectomy offers shorter surgery times and fewer complications. This approach leads to better patient outcomes and faster recovery.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery

Background:

  • Treatment guidelines for perforated appendicitis with periappendiceal abscess, without generalized peritonitis, are lacking.
  • This clinical scenario presents a challenge in pediatric surgical management.

Purpose of the Study:

  • To evaluate the efficacy of a conservative management approach for perforated appendicitis with abscess.
  • To compare outcomes between conservative and immediate appendectomy strategies.

Main Methods:

  • Retrospective review of six pediatric cases with perforated appendicitis and abscess.
  • Analysis of treatment strategies: conservative antibiotic therapy with interval appendectomy versus immediate appendectomy.

Main Results:

  • Conservative management was associated with shorter surgery duration.
  • Fewer overall hospital days and faster refeeding were observed with the conservative approach.
  • The conservative strategy resulted in a lower incidence of complications.

Conclusions:

  • Initial conservative management with interval appendectomy is a viable and beneficial approach.
  • This strategy is recommended for perforated appendicitis with abscess and coprolith, with appendectomy within 4 months post-discharge.
Abstract

Keywords:
AbscessAcute appendicitisAntibiotic therapyAppendicolithInterval appendectomy

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