Does Ruptured Appendicitis with Abscess Warrant Urgent Operative Intervention?
Ruptured appendicitis with abscess formation occurs in up to 10% of patients with appendicitis. When interventional radiology (IR) is available, initial nonsurgical management with percutaneous drainage and IV antibiotics should be attempted, followed by interval appendectomy. Acute operative intervention may increase morbidity and should generally be reserved for patients with large ill-defined abscess, extraluminal appendicolith, and/or life-threatening peritonitis. It should also be considered when IR is unavailable.
KeywordsRuptured appendicitis Intra-abdominal abscess Appendix Conservative management Operative intervention Surgery Interventional radiology
- 1.Cheng Y, Xiong X, Lu J, Wu S, Zhou R, Cheng N. Early versus delayed appendicectomy for appendiceal phlegmon or abscess. Cochrane Database Syst Rev. 2017;2:6. https://doi.org/10.1002/14651858.CD011670.pub2.
- 6.Craig S. Appendicitis treatment and management. Medscape [Internet] 2017, January 19. Available from: http://emedicine.medscape.com/article/773895-treatment.
- 8.Duggan E, Marshall A, Weaver K, St Peter S, Tice J, Wang L, Choi L, Blakely M. A systematic review and individual patient data meta-analysis of published randomized clinical trials comparing early versus interval appendectomy for children with perforated appendicitis. Pediatr Surg Int. 2016;32(7):649–55. https://doi.org/10.1007/s00383-016-3897-y.CrossRefPubMedGoogle Scholar
- 12.Salari A. Perforated appendicitis, current concepts in colonic disorders. INTECH. 2012. Available from: http://www.intechopen.com/books/current-concepts-incolonic-disorders/perforated-appendicitis. ISBN: 978-953-307-957-8.