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[Post-appendectomy intra-abdominal abscesses: six years' experience in a Pediatric Surgery Department]
A Coelho1, C Sousa1, A S Marinho1
1Serviço de Cirurgia Pediátrica. Centro Materno Infantil do Norte. Centro Hospitalar do Porto EPE. Portugal.
Insights
Post-appendectomy intra-abdominal abscesses occurred in 1.79% of cases. Conservative management showed an 83.3% success rate, with only 4 patients requiring surgical re-intervention.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Infectious Disease
Background:
- Post-appendectomy intra-abdominal abscesses are a known complication, with reported incidences ranging from 6.7% to 28% for perforated appendicitis.
- Understanding the incidence and effective treatment of these abscesses is crucial for pediatric surgical care.
Purpose of the Study:
- To review and characterize post-appendectomy intra-abdominal abscesses in a pediatric surgery department.
- To determine the incidence of these abscesses.
- To evaluate the efficacy of current treatment modalities.
Main Methods:
- Retrospective analysis of pediatric patients diagnosed with intra-abdominal abscess post-appendectomy (January 2010 - December 2015).
- Data collected included initial surgical approach, appendicitis type, hospital stay, and treatment applied.
- Review of clinical files for data extraction.
Main Results:
- A total of 1,340 appendectomies were performed, with 24 intra-abdominal abscesses identified, resulting in an incidence of 1.79%.
- The mean age of affected patients was 11.9 years; 52% were diagnosed during initial admission.
- Conservative management was successful in 83.3% of cases, with only 4 patients requiring surgical re-intervention.
Conclusions:
- The incidence of post-appendectomy intra-abdominal abscesses in this pediatric cohort is lower than reported in the literature.
- Conservative management is highly effective for post-appendectomy intra-abdominal abscesses in children, minimizing the need for repeat surgery.
Objectives:
Post-appendectomy intra-abdominal abscesses are estimated to complicate up to 4.2% of acute non-perforated appendicitis and between 6.7% and 28% acute perforated appendicitis. This study was performed with the aim to review and characterize post-appendectomy intra-abdominal abscesses in our Pediatric Surgery department; to calculate their incidence and to evaluate the efficacy of the treatment modality.
Material And Methods:
A retrospective analysis of all patients, under 18 years and with the diagnosis of intra-abdominal abscess post-appendectomy, between January 2010 and December 2015 was performed, taking in account initial surgical approach, type of acute appendicitis, length of hospital stay and the treatment applied. Data were collected by reviewing clinical files.
Results:
In a total of 1,340 appendectomies performed, there were 24 intra-abdominal abscesses identified (1.79%). Eight were feminine and sixteen masculine, and mean age was 11.9 years. In 52% of cases the diagnosis was made in the initial admission. Twelve have been submitted to laparoscopic appendectomy and the other 12 to open appendectomy. Of the 24 patients, only 4 needed a surgical re-intervention, which leaves medical treatment an 83.3% success rate.
Conclusions:
TThe incidence of intra-abdominal abscesses post-appendectomy, in the studied population, is what was expected and inferior to what's described in the literature. In our sample, conservative management for intra-abdominal abscesses post-appendectomy was successful in most of the cases, only 4 needing further surgical intervention.