Medical treatment of postappendectomy intraperitoneal abscesses in children.
Treatment of postappendectomy intraperitoneal abscesses is classically surgical (drainage). We report a retrospective study (1988 to 1991) of our experience in providing exclusively medical treatment for 11 such isolated abscesses in children. The abscess was detected 7 times within the 10 days following appendectomy. Ultrasonography localized the abscess 7 times in the right iliac fossa and 4 times in Douglas' pouch. In 4 cases it was larger than 5 cm in diameter. Parenteral antibiotic therapy associated ticarcillin and clavulanic acid 6 times and piperacillin, tobramycin and metronidazole 5 times. Drug efficacy was evaluated by clinical signs (fever, pain, ileus) and ultrasonography. In one case, an associated ileus led to reoperation at day 4 of treatment. In the other 10 cases, clinical signs disappeared during the first week of treatment. At day 7, parenteral was replaced by oral antibiotic therapy (metronidazole 7 times, amoxicillin-clavulanic acid 3 times) continued until the abscess was no longer visualized on ultrasonography (5 times at 3 weeks, 5 times at 1 month). Medical treatment of isolated postappendectomy abscesses in children would thus appear to be a logical choice in the absence of an associated ileus.
Héloury
Y
Y
Chirurgie Infantile, Hôpital Mère-Enfant, Nantes, France.
Baron
M
M
Bourgoin
S
S
Wetzel
O
O
Lejus
C
C
Plattner
V
V
D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D000284:Administration, Oral; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001062:Appendectomy; D002648:Child; D003131:Combined Modality Therapy; D004322:Drainage; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010538:Peritonitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography
D000900:Anti-Bacterial Agents