Abstract

AIM: The authors carried out a standard protocol to show the value of nonoperative modalities in postappendectormy abdominal abscess. Forty patients with abdominal abscess after appendectomy were determined results are evaluated. MATERIAL AND METHOD: The patients evaluated as presumed appendicitis were operated between January 2000 and December 2007. Preoperative antibiotic regimen was consisted from ampicillin and gentamycin. Patients with complicated by postappendectormy intraabdominal abscess were received triple antibiotics (ampicillin-sulbactam, aminoglycoside and metranidazole). Common findings of abscess are fever, intolerance of diet, abdominal discomfort and lengthening of the hospitalization. Management included intravenous administration of antibiotics effective against both aerobes and anaerobes, and follow up with serial sonographic studies. FINDINGS: Between January 2000 and December 2007 1258 appendectomies were performed. The 463 of them were perforated appendicitis. Of remaining 795 patients, 749 were acute appendicitis. Appendixes of 46 patients were normal. Among 1258 patients, 40 of them were complicated with postoperative intraabdominal abscess. In all but two patients with intraabdominal abscess medical treatment was enough. Thirty-eight patients responded favorably to antibiotic treatment without any drainage procedure, with gradual shrinkage and collapse of abscess cavity. CONCLUSION: In pediatric population, intraabdominal abscess after appendectomy can be managed conservatively with the authors' current protocol. Intravenous administration of triple antibiotics, follow up with serial sonographic studies are majör components of nonoperative management.