Interval laparoscopic appendectomy after laparotomy drainage for acute appendicitis with abscess: A case report

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Surgery

Background:

• Acute appendicitis with abscess presents treatment challenges, often leading to complications.
• Immediate surgery risks ileocecal resection and postoperative issues compared to interval appendectomy.
• Optimal management for appendicitis with abscess remains debated.

Purpose of the Study:

• To present a case of perforated appendicitis with abscess managed conservatively.
• To evaluate the efficacy of laparotomy drainage and interval appendectomy.

Main Methods:

• A 69-year-old female patient with a cecal abscess underwent conservative treatment.
• Laparotomy drainage was performed due to difficulties with percutaneous drainage.
• Interval laparoscopic appendectomy was conducted three months post-discharge.

Main Results:

• Laparotomy drainage successfully managed the abscess and improved the patient's condition.
• The patient experienced an uneventful recovery after interval laparoscopic appendectomy.
• Colonoscopy ruled out underlying malignancy.

Conclusions:

• Conservative management, including antibiotic therapy and laparotomy drainage, is a viable first-line approach for appendicitis with abscess.
• Laparotomy offers direct abscess access, minimizing spread risk.
• Interval laparoscopic appendectomy is effective for appendix removal and preventing recurrence.