title: Nonoperative management of appendiceal phlegmon or abscess with an appendicolith in children.
abstract: BACKGROUND
  The optimal treatment of appendiceal phlegmon or abscess with an appendicolith is controversial. This study aimed to evaluate outcomes and prognosis of nonoperative management of appendiceal phlegmon or abscess with an appendicolith in children.
  
  
  METHODS
  From 2007 to 2011, 105 children with appendiceal phlegmon or abscess who were treated nonoperatively without interval appendectomy were reviewed. Average follow-up of subjects was 2.4 years. Data were compared between subjects with and without an appendicolith or persistent presence and disappearance of an appendicolith.
  
  
  RESULTS
  The success rate for nonoperative therapy for appendiceal phlegmon or abscess with appendicolith was 95.9 %. The risk of recurrent appendicitis in appendiceal phlegmon or abscess with appendicolith (19.1 %) was higher than that without appendicolith (8.9 %, P = 0.132). The rate of appendicolith disappearance during follow-up was 80.9 %. The persistent presence of an appendicolith was associated with a significantly higher recurrence rate (66.7 %) compared with appendicolith disappearance (7.9 %, P < 0.05).
  
  
  CONCLUSIONS
  Appendiceal phlegmon or abscess with an appendicolith can be managed nonoperatively, and most appendicoliths can be resolved. Persistent presence of an appendicolith is a significant risk factor for recurrent appendicitis. Interval appendectomy is recommended for persistent presence of appendicolith, but is not indicated in cases without appendicolith or appendicolith disappearance.
authors: Department of Pediatric Surgery, Shengjing Hospital of China Medical University, No. 36 Sanhao St, Heping District, Shenyang, China, 110004.
authors: Hai-Lan
authors: HL
authors: Zhang
authors: Yu-Zuo
authors: YZ
authors: Bai
authors: Xin
authors: X
authors: Zhou
authors: Wei-Lin
authors: WL
authors: Wang
mesh_terms: D000038:Abscess / Q000150:complications / Q000628:therapy*; D001064:Appendicitis / Q000150:complications / Q000628:therapy*; D002114:Calcinosis / Q000150:complications / Q000628:therapy*; D002481:Cellulitis / Q000150:complications / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies