Elective interval laparoscopic management for periappendiceal abscess.
BACKGROUND
In Far Eastern countries, the right-sided colonic diverticular diseases are more prevalent than the left-sided ones. Accurate differential diagnosis between appendiceal abscess and right-sided diverticulitis with abscess formation is difficult to make preoperatively. Conservative treatment followed by elective interval surgery remains the mainstay of management for patients with periappendiceal abscess. Laparoscopic diagnosis and treatment have been advocated in managing patients with abdominal pain of uncertain diagnosis. The purpose of this study was to evaluate the beneficial effect of interval barium enema and mini-invasive procedures for patients with periappendiceal abscess.


METHODS
Patients with periappendiceal abscess (n = 8) were enrolled in this study. Conservative treatment was instituted by administration of antibiotics, and interval barium enema and laparoscopic intervention were scheduled later. Clinical manifestations, results of barium enema, outcomes of laparoscopic intervention and pathological diagnoses were reviewed.


RESULTS
The frequency of periappendiceal abscess was 18/263 (6.8%). There were no operative complications. The correlation between barium enema, laparoscopic findings, and pathological diagnosis was quite good. Patients gained the advantages of laparoscopic surgery.


CONCLUSIONS
Interval barium enema study and laparoscopic diagnosis and treatment are worthy of trying for patients with periappendiceal abscess, especially in those areas with high prevalence of right-sided diverticular diseases.
Hsia
C Y
CY
Department of Surgery, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Chiu
J H
JH
Lui
W Y
WY
D000038:Abscess / Q000601:surgery*; D000328:Adult; D000368:Aged; D001065:Appendix; D001466:Barium Sulfate; D002429:Cecal Diseases / Q000601:surgery; D004733:Enema; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged
D001466:Barium Sulfate