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Effectiveness of Interval Appendectomy After Conservative Treatment of Pediatric Ruptured Appendicitis with Abscess

Takeshi Furuya1, Mikiya Inoue2, Kiminobu Sugito1

  • 1Department of Pediatric Surgery, Nihon University School of Medicine, 30-1, Ohyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610 Japan.

The Indian Journal of Surgery
|March 25, 2016
PubMed

Insights

Interval appendectomy for pediatric perforated appendicitis with abscess significantly lowers infection rates. This approach, following initial antibiotic treatment, proves safer than immediate surgery, reducing complications like wound infections and intra-abdominal abscesses.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery
  • Infectious Disease Management

Background:

  • Management of acute perforated appendicitis with abscess in children remains a clinical challenge.
  • Treatment strategies vary, with ongoing debate regarding the optimal timing of surgical intervention.

Purpose of the Study:

  • To evaluate and compare treatment outcomes for pediatric patients with perforated appendicitis and abscess.
  • To assess the efficacy of emergency surgery versus interval surgery after conservative management.

Main Methods:

  • Retrospective analysis of 31 pediatric patients diagnosed with appendicitis and abscess.
  • Patients were categorized into two groups: immediate (emergency) operation and delayed (interval) operation after antibiotic therapy.
  • Clinical data and treatment outcomes, including infectious complications and hospital stay, were compared between groups.

Main Results:

  • No significant differences were observed in baseline characteristics between the emergency and interval operation groups.
  • The emergency operation group experienced higher rates of postoperative complications, including wound infection (40%) and intra-abdominal abscess (26.7%).
  • The interval operation group, following conservative antibiotic treatment, reported no infective complications.

Conclusions:

  • Interval appendectomy after initial conservative management for pediatric perforated appendicitis with abscess is associated with significantly reduced postoperative infection rates.
  • This strategy appears to be a safer approach, minimizing surgical site infections and intra-abdominal abscesses in this patient population.

Keywords:
AbscessAppendicitisChildInterval appendectomy

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