Comparison of therapeutic effectiveness of percutaneous drainage with antibiotics versus antibiotics alone in the treatment of periappendiceal abscess

Abstract

Percutaneous drainage with antibiotics is a safe and effective way of treating acute perforated appendicitis. The recurrence rate for these patients is relatively low, and very often interval appendectomy is not required. For patients with periappendiceal abscess> or = 3 cm in diameter, antibiotic therapy alone is insufficient and the recurrence rate is high.

Therapeutic Consideration of Periappendiceal Abscess: an Evaluation of Non-surgical Treatment Followed by Minimally Invasive Interval Appendectomy

“…Previous studies reported a high success rate of 76~97% for non-surgical treatment. [2][3][4][5][6][7][8] In the present study, there were 3 cases (3.6%) of treatment failure in non-surgical management. Two of them underwent emergent surgery under septic condition due to deterioration of inflammation despite initial antibiotic treatment.…”

“…[27][28][29] After successful conservative or/and image-guided drainage management, IA is often not necessary and can safely be omitted, except in patients with recurrent symptoms. 1,2,10,30 However, proponents of IA point to advantages of initial conservative treatment followed by IA; the approach avoids the recurrence of symptoms and the misdiagnosis of alternative pathologies, such as malignancy, tuberculosis, diverticulosis, and Crohn' s disease. 9,10 In our study period, after non-surgical treatment, one patient had appendiceal cancer, and four had Crohn's disease.…”

“…1 Conservative management using antibiotics alone and image-guided percutaneous drainage for patients with PAA has achieved high success rates of 76% to 97%, with a low incidence of complications. [2][3][4][5][6][7][8] After achieving complete resolution of the inflammatory mass with non-surgical treatment, interval appendectomy (IA) is a less hazardous and less challenging operation, compared with ES. However, IA requires extra hospitalization for surgery and can take a long time from the time of illness to the end of treatment.…”

The Martian chronicles: remotely guided diagnosis and treatment in the arctic circle

“…Appendicitis has been managed in constrained conditions with antibiotics and bowel rest. However, increased morbidities and recurrent appendicitis have been seen in these patients [20][21][22][23][24].…”

An interesting case of acute abdomen

“…14 Abscesses larger than 3 cm can be considered serious 15 16 and are unlikely to resolve with antibiotics alone. 17 Open drainage or appendicectomy can lead to an infection of the wound in up to 16% of patients. 18 In all cases of right iliac fossa mass, a carcinoma of the colon should be excluded.…”