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Appendiceal abscess

D L Paull, G P Bloom

    Archives of Surgery (Chicago, Ill. : 1960)
    |August 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Many patients with appendiceal abscess can be treated nonoperatively or with drainage alone, avoiding immediate appendectomy. Recurrence rates are low, suggesting interval appendectomy may not be necessary for all patients.

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    Area of Science:

    • Gastroenterology
    • Surgical Oncology

    Background:

    • Appendiceal abscess and mass are common surgical emergencies.
    • Optimal management strategies remain under investigation.

    Purpose of the Study:

    • To evaluate the outcomes of different management strategies for appendiceal abscess.
    • To determine the necessity of immediate or interval appendectomy.

    Main Methods:

    • Retrospective review of 61 patients with appendiceal abscess.
    • Comparison of outcomes for nonoperative management, incision and drainage (I&D) with and without appendectomy, and interval appendectomy.

    Main Results:

    • Nonoperative management and I&D without appendectomy showed lower morbidity (16%) compared to I&D with appendectomy (24%).

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  • Average hospitalization was shortest for nonoperatively treated patients.
  • Recurrence rate of appendicitis after non-operative management was 5% with a 9.1-month follow-up.
  • Morbidity for elective interval appendectomy was 13%.

    • Conclusions:

    • Many patients with appendiceal abscess or mass do not require immediate surgical intervention.
    • Nonoperative management or drainage alone can be effective, with low recurrence rates.
    • Interval appendectomy may not be necessary in all cases, particularly when fecaliths are removed during initial drainage.