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Related Experiment Videos

Two-step procedure for complicated appendicitis with perityphlitic abscess formation.

Almir Miftaroski1, Ulf Kessler1, Etienne Monnard2

  • 1Department of Surgery, HFR Fribourg - Cantonal Hospital Fribourg, Switzerland.

Swiss Medical Weekly
|April 20, 2017
PubMed
Summary

This study shows a two-step procedure for perforated appendicitis with abscess is highly successful. The treatment involves antibiotics and drainage, followed by interval appendectomy, with a 100% success rate and low complication rate.

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Area of Science:

  • Gastroenterology
  • Surgical Procedures
  • Infectious Disease Management

Background:

  • Management of perforated appendicitis with abscess remains controversial.
  • A two-step approach involving initial non-operative management followed by interval surgery is one strategy.

Purpose of the Study:

  • To evaluate the outcomes of a two-step procedure for treating perityphlitic abscess.
  • To assess the efficacy and complication rates of this management strategy.

Main Methods:

  • Retrospective analysis of prospectively collected data from adult patients (2007-2015).
  • Inclusion criteria: appendicitis with perityphlitic abscess (>=3 cm) without generalized peritonitis.
  • Two-step procedure: antibiotic therapy and drainage (if feasible), followed by interval appendectomy.

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Main Results:

  • 15 patients with perityphlitic abscess were identified out of 1480 appendicitis cases.
  • 12 patients received computed tomography-guided drainage alongside antibiotics.
  • Median hospital stay was 7 days for step 1 and 2 days for step 2.
  • One recurrence and one reoperation were noted.

Conclusions:

  • The two-step procedure for appendicitis with appendicular abscess demonstrated high success (100%) with a low complication rate (13%).
  • Further larger trials are needed to evaluate the role of interval appendectomy, considering the potential for appendiceal neoplasm.