Appendiceal abscesses: primary percutaneous drainage and selective interval appendicectomy.
OBJECTIVE
To present our results of non-surgical primary management of appendiceal abscesses using ultrasonic percutaneous drainage under local anaesthesia, and selective interval appendicectomy.


METHODS
Retrospective study.


METHODS
University hospital, Sweden.


METHODS
24 patients with appendiceal abscesses 3-12 cm in size.


METHODS
Primary ultrasonic percutaneous drainage under local anaesthesia, antibiotic treatment, and selective surgical treatment.


METHODS
Long-term follow-up.


RESULTS
All patients had their abscesses drained successfully without complications. One patient continued to have fever, but eventually responded to conservative treatment and in one the bowel was perforated by the drain but again this was treated conservatively. Four abscesses recurred. Seven patients underwent planned interval appendicectomy. Another three patients were also operated on-one for caecal adenocarcinoma, and two for persisting symptoms and enterocutaneous fistulas.


CONCLUSIONS
Appendiceal abscesses can be effectively drained percutaneously using ultrasound-guided drainage under local anaesthesia, without complications. Recurrent appendicitis is common, and malignancy is a substantial risk in elderly patients. Modern laparoscopic appendicectomy and early postoperative discharge makes interval appendicectomy a valid treatment option after primary non-surgical management of appendiceal abscesses.
Lasson
Ake
A
Department of Diagnostic Radiology, Malmö University Hospital, University of Lund, Sweden.
Lundagårds
Jan
J
Lorén
Ingemar
I
Nilsson
Paul E
PE
D000038:Abscess / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001065:Appendix; D002429:Cecal Diseases / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome