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Conservative treatment of intra-abdominal abscess in children
Insights
Most pediatric intra-abdominal abscesses (IAA) can be successfully treated with antibiotics alone, avoiding surgery. Close sonographic monitoring is crucial for effective management and determining when surgical intervention is necessary.
Area of Science:
- Pediatric Surgery
- Diagnostic Imaging
Background:
- Intra-abdominal abscesses (IAA) in children require effective management strategies.
- Sonography is a key tool for diagnosing and monitoring IAA.
Purpose of the Study:
- To evaluate the effectiveness of conservative antibiotic treatment for pediatric intra-abdominal abscesses.
- To determine the role of sonography in managing pediatric IAA.
Main Methods:
- Retrospective study of 53 children with sonogram-proved IAA.
- Analysis of treatment outcomes, including antibiotic therapy and surgical intervention.
- Serial sonographic follow-up to assess abscess resolution.
Main Results:
- 79.3% of patients responded favorably to antibiotics without drainage.
- Abscesses resolved in an average of 27.9 days with antibiotic treatment.
- Surgical intervention was required for 11 patients with deteriorating conditions.
Conclusions:
- Conservative antibiotic management is effective for most pediatric intra-abdominal abscesses.
- Close sonographic monitoring is essential for successful treatment and timely surgical consideration.
- Antibiotics alone can manage IAA, but surgery remains necessary for persistent or worsening cases.
Abstract:
Fifty-three children under 18 years of age with sonogram-proved intra-abdominal abscess (IAA) were seen between July 1993 and June 1996 at the Department of Pediatrics of the Mackay Memorial Hospital, then were studied retrospectively. Following a course of conservative treatment and follow-up with serial sonographic studies, 42 (79.3%) patients responded favourably to antibiotics treatment without drainage procedure. The other 11 patients' condition deteriorated, and surgical intervention was performed. The gradual shrinkage and completely resolved periods of the abscesses averaged 27.9 days. The average duration of antibiotic treatment was 23.6 days, intravenously for average 12.2 days followed by oral treatment until the abscess was completely resolved (average 11.4 days). The intra-abdominal abscess recurred in 3 (5.7%) patients. The experience demonstrates that pediatric patients with an intra-abdominal abscess must be followed closely by sonography, and they can be managed successfully with appropriate antibiotics alone. Surgical intervention is still needed if symptoms and signs persist or deteriorate.