Thursday, February 27, 2020

Abcess in perforated appendectomy

Q: In patients who have perforated appendicitis with abscess formation. Which of the following approach is preferred? 

A) Percutaneous abscess drainage 
B) Immediate surgical exploration

Answer: A

In perforated acute appendicitis with abscess formation computed tomography (CT) or ultrasound (US)-guided drainage can be performed either percutaneously or transrectally. This approach seems to result in fewer complications and a shorter length of stay (LOS). Also, it allows inflammation to subside before appendectomy, and fewer chances of extended bowel resection.



1. Oliak D, Yamini D, Udani VM, et al. Initial nonoperative management for periappendiceal abscess. Dis Colon Rectum 2001; 44:936. 

2. Gee D, Babineau TJ. The optimal management of adult patients presenting with appendiceal abscess: "conservative" vs immediate operative management. Curr Surg 2004; 61:524. 

3. Brown CV, Abrishami M, Muller M, Velmahos GC. Appendiceal abscess: immediate operation or percutaneous drainage? Am Surg 2003; 69:829.

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