Perforated appendix with abscess: Immediate or interval appendectomy? Some examples to explain our choice. (2015)

• Record Type: Journal Article
• Authors: Guida, Edoardo; Pederiva, Federica; Grazia, Massimo Di; Codrich, Daniela; Lembo, Maria Antonietta; Scarpa, Maria Grazia; Rigamonti, Waifro
• Is Part Of: International journal of surgery case reports. Volume 12(2015)
• Page Start: 15
• Page End: 18
• Publication Date: 2015
• Subjects: CT computed tomography -- CVC central catheter venous -- IA interval appendectomy -- NT naso-gastric tube -- US ultrasonography -- VC vesical catheter; Interval appendectomy -- Appendicolith -- Antibiotic therapy -- Acute appendicitis -- Abscess; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2015.05.003
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: There are no clear guidelines in the treatment of a perforated appendicitis associated with localized abscess. Our team's therapeutic choice, also with presence of coprolith, is the initial conservative case management followed by a routine interval appendectomy. Interval appendectomy should be performed not later than 4 months after discharge. Abstract: Introduction: There are no clear guidelines in the treatment of a perforated appendicitis associated with periappendiceal abscess without generalized peritonitis. Presentation of cases: We retrospectively studied six examples of treated children in order to discuss the reasons of our team's therapeutic approach. Some children were treated with a conservative antibiotic therapy to solve acute abdomen pain, planning a routine interval appendectomy after some months. Others, instead, underwent an immediate appendectomy. Discussion: By examining these examples we wanted to highlight how the first approach may be associated with shorter surgery time, fewer overall hospital days, faster refeeding and minor complications. Conclusion: Our team's therapeutic choice, in the case of a perforated appendicitis with an abscess and coprolith is an initial conservative case management followed by a routine interval appendectomy performed not later than 4 months after discharge.