PMID: 8938362Feb 1, 1996Paper

Recurrent appendicitis after initial conservative management of appendiceal abscess

Journal of Pediatric Surgery
M R PriceD P Meagher

Abstract

Therapy for children with appendiceal abscess remains controversial. The authors present two such cases initially treated conservatively, without interval appendectomy, that later had recurrent appendicitis. An 8-year-old boy presented with fever, abdominal pain, and a right-lower-quadrant abscess (noted by ultrasonography). During laparotomy, the abscess was drained and the appendix was not found. He was lost to follow-up but returned 2 1/2 years later with perforated appendicitis. An appendectomy was performed, and image-guided drainage of a postoperative abscess was required. A 10-year-old girl presented with fever and right-lower-quadrant pain. Computed tomography showed a multiloculated mass. During laparotomy, the cecum was found to be densely adherent to the pelvic organs and bowel, so the surrounding abscess was drained. Interval appendectomy was refused. The patient returned 8 months later with recurrent acute appendicitis and an appendiceal abscess requiring appendectomy and drainage. Although initial drainage alone of appendiceal abscess is efficacious, the authors strongly advocate interval appendectomy as a critical component of the complete management of this entity.

References

Feb 1, 1978·Archives of Surgery·E L Bradley, J Isaacs
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Citations

May 6, 2011·Pediatric Radiology·Mark J Hogan
Nov 2, 2012·Pediatric Radiology·Mark J HoganUNKNOWN Society for Pediatric Radiology Interventional Radiology Committee
Aug 24, 2000·Surgical Endoscopy·Z LidarA Ayalon
Dec 16, 2003·American Journal of Surgery·Thomas R WeberKim Vierling
Feb 20, 2004·Current Surgery·Rodrick McKinlay, Michael J Mastrangelo
Feb 20, 2004·Current Surgery·Tommy SheltonRichard W Schwartz
Oct 31, 2001·The British Journal of Surgery·J GillickP Puri
May 29, 2008·World Journal of Gastroenterology : WJG·George SgourakisChristoph Berchtold
Dec 22, 2005·World Journal of Surgery·Dennis W Vane, Nathanial Fernandez
May 17, 2011·World Journal of Surgery·Wan-Ching LienChien-Jen Chen
Oct 30, 2012·Journal of Vascular and Interventional Radiology : JVIR·Mark J HoganUNKNOWN Society of Interventional Radiology Standards of Practice Committee and Society for Pediatric Radiology Interventional Radio
Sep 21, 2010·Journal of Pediatric Surgery·Mehul V RavalMarybeth Browne
Mar 22, 2000·Journal of Pediatric Surgery·D B Gahukamble, L D Gahukamble
Mar 26, 2014·The Journal of Trauma and Acute Care Surgery·Mark W MaxfieldKimberly A Davis
Jun 23, 2020·Pediatrics International : Official Journal of the Japan Pediatric Society·Yoshiaki TakahashiTomoaki Taguchi

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