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Abscess after appendicectomy in children: the role of conservative management
B O Okoye1, B Rampersad, A Marantos
1Department of Paediatric Surgery, Alder Hey Children's Hospital, University of Liverpool, UK.
Insights
Antibiotic therapy alone is effective for treating intra-abdominal abscesses in children after appendicectomy. Surgical drainage is rarely needed, making non-operative management a safe first-line approach for pediatric appendiceal abscess.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
Background:
- Intra-abdominal abscess is a common complication following appendicectomy in children.
- Non-operative management using antibiotics alone has received limited attention for this pediatric complication.
Purpose of the Study:
- To review the experience of a pediatric surgical department in managing post-appendicectomy abscesses.
- To evaluate the efficacy of non-operative antibiotic management in pediatric patients.
Main Methods:
- Retrospective review of hospital records for children undergoing appendicectomy between January 1992 and January 1997.
- Analysis of outcomes for patients who developed intra-abdominal abscesses post-appendicectomy.
Main Results:
- Out of 1024 children, 23 (2.2%) developed post-appendicectomy abscesses.
- Non-operative management with antibiotics alone achieved successful resolution in 21 of 23 patients.
- Surgical drainage was required in only two cases (laparotomy and transrectal).
Conclusions:
- Antibiotic therapy alone is an effective and safe first-line treatment for pediatric intra-abdominal abscesses post-appendicectomy.
- Surgical intervention for post-appendicectomy abscesses is infrequently necessary in children.
Background:
Intra-abdominal abscess remains a significant cause of morbidity following appendicectomy. In children, little emphasis has been placed on the non-invasive management of this complication using antibiotic therapy alone. This study reviews the experience of a paediatric surgical department in managing abscess arising after appendicectomy.
Methods:
Hospital records of all children undergoing appendicectomy between January 1992 and January 1997 were reviewed retrospectively.
Results:
Some 1024 children underwent appendicectomy over a 5-year period. Twenty three patients (2.2 per cent) developed abscesses after appendicectomy. Non-operative management with intravenous or oral antibiotics alone was successful in 21 patients, with complete clinical and radiological resolution of the abscess. Drainage of the septic collection was performed in only two patients: by laparotomy (n=1) and by the transrectal route (n=1).
Conclusion:
Antibiotic therapy alone is an efficacious and safe first-line treatment modality in children who develop this complication. Drainage of an abscess developing after appendicectomy is rarely necessary in children.
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