title: Appendiceal abscesses: primary percutaneous drainage and selective interval appendicectomy.
abstract: 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.
authors.affiliation: Department of Diagnostic Radiology, Malmö University Hospital, University of Lund, Sweden.
authors.forename: Ake
authors.initials: A
authors.lastname: Lasson
authors.forename: Jan
authors.initials: J
authors.lastname: Lundagårds
authors.forename: Ingemar
authors.initials: I
authors.lastname: Lorén
authors.forename: Paul E
authors.initials: PE
authors.lastname: Nilsson
mesh_terms: 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