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Treatment of appendiceal abscess
1Department of Surgery, Nacka Hospital, Stockholm, Sweden.
Acta Chirurgica Scandinavica
|February 1, 1988
Summary
Conservative management of appendiceal abscesses is effective, with lower complication rates than surgery. Interval appendectomy is not routinely recommended, especially for older patients who require further investigation for malignancy.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Appendiceal abscesses are a significant clinical challenge.
- Treatment strategies have evolved, necessitating a review of outcomes.
Purpose of the Study:
- To evaluate the efficacy and complication rates of different management strategies for appendiceal abscess.
- To establish an evidence-based approach for appendiceal abscess treatment.
Main Methods:
- Retrospective review of 193 patients with appendiceal abscess over 14 years.
- Comparison of complication and recurrence rates between nonsurgical and surgical treatment groups.
- Analysis of outcomes following 'interval' elective appendectomy.
Main Results:
- Nonsurgical management had a significantly lower complication rate (3%) compared to surgical treatment (32%).
- Recurrence rate was low (3%) in patients not undergoing appendectomy.
- 'Interval' appendectomy had a 23% complication rate.
Conclusions:
- Initial conservative treatment for appendiceal abscess is recommended, with surgery reserved for treatment failures.
- Routine 'interval' appendectomy is not advised.
- Patients over 40 require thorough investigation, including imaging and potentially laparotomy, to rule out malignancy.