Post-Appendectomy Intra-Abdominal Abscess in Children with Perforated Appendicitis: A Narrative Review

Area of Science:

• Pediatric Surgery
• Infectious Diseases
• Gastroenterology

Background:

• Post-appendectomy intra-abdominal abscess (PAA) is a significant complication in children following perforated appendicitis.
• PAA leads to extended hospital stays, readmissions, and increased healthcare costs.
• Current management strategies for PAA exhibit considerable heterogeneity.

Purpose of the Study:

• To review the pathophysiology, risk factors, diagnosis, clinical impact, and treatment of PAA in pediatric patients.
• To synthesize current evidence on managing PAA in children.
• To highlight the need for standardized approaches to PAA management.

Main Methods:

• This study is a narrative review of existing literature.
• Evidence was synthesized regarding PAA pathophysiology, risk factors, diagnostic methods, and therapeutic options.
• Focus was placed on the pediatric population.

Main Results:

• PAA commonly occurs after perforated appendicitis due to persistent contamination and fibrin loculation.
• Predictors include fecaliths, perforation severity, and inflammatory markers.
• Ultrasound is the primary diagnostic tool, typically used in the second postoperative week.

Conclusions:

• PAA significantly impacts pediatric healthcare utilization and costs.
• Management approaches vary widely, from antibiotics to surgical drainage.
• There is an urgent need for standardized definitions, predictive tools, and high-quality trials to optimize PAA care in children.