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Early appendectomy versus an interval appendectomy for appendiceal abscess in children
N Handa1, K Muramori, S Taguchi
1Department of Pediatric Surgery, Oita Prefectural Hospital, Japan.
Fukuoka Igaku Zasshi = Hukuoka Acta Medica
|February 18, 1998
Summary
For children with perforated appendicitis and abscess, conservative treatment with antibiotics followed by interval appendectomy is recommended. This approach avoids complications associated with early appendectomy, offering a safer strategy for pediatric appendiceal abscess management.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Appendicitis is a common surgical emergency in children.
- Perforated appendicitis with localized abscess presents treatment challenges.
- Early appendectomy versus conservative management is debated.
Purpose of the Study:
- To compare outcomes of early appendectomy versus interval appendectomy after conservative management in pediatric perforated appendicitis with abscess.
- To evaluate operative time, blood loss, complications, hospital stay, and costs.
Main Methods:
- Retrospective comparative study.
- Two groups: early appendectomy (n=8) and interval appendectomy after conservative treatment (n=6).
- Conservative management included triple antibiotic therapy.
Main Results:
- Early appendectomy group had longer operation times, greater blood loss, and more postoperative complications.
- Interval appendectomy group had successful conservative management without abscess drainage or complications.
- No significant differences in hospital stay or medical costs between groups.
Conclusions:
- Initial conservative treatment followed by interval appendectomy is a useful strategy for pediatric appendiceal abscesses.
- This approach may reduce complications compared to early surgery.
- Further research is needed to determine the applicability of interval appendectomy in all antibiotic-treated cases.