Post-appendectomy intra-abdominal abscesses can they successfully be managed with the sole use of antibiotic therapy?

被引:23
|
作者
Forgues, D. [1 ]
Habbig, S. [1 ]
Diallo, A. F. [1 ]
Kalfa, N. [1 ]
Lopez, M. [1 ]
Allal, H. [1 ]
Guibal, M. P. [1 ]
Sabatier-Laval, E. [1 ]
Galifer, R. B. [1 ]
机构
[1] Univ Montpellier, Hop Lapeyronie, Dept Visceral Paediat Surg, F-34295 Montpellier 5, France
关键词
post-appendectomy intra-abdominal abscess; antibiotic treatment; drainage;
D O I
10.1055/s-2007-965015
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Purpose: Controversy persists concerning the management of post-appendectomy intra-abdominal abscesses. We hypothesised that most of these abscesses can be sucessfully managed by antibiotic treatment alone, avoiding the complications of surgical treatment. Methods: Hospital records of children treated in our unit for intra-abdominal post-appendectomy abscesses over a 6-year period were reviewed retrospectively. Results: This study investigates a series of 26 children from 2 to 15 years of age presenting with one or more post-appendectomy intra-abdominal abscesses. After an average delay of 7 days after initial surgery, 23 children had developed an isolated abscess, while 3 children had multiple abscesses. Twenty-two patients (84.8%) were treated conservatively by intravenous triple antibiotic therapy alone. Complete clinical, radiological and biological resolution of the abscesses was obtained in all of these children after a mean hospitalisation of 8 days. Four children (15.2%) were treated surgically: three children with a stable patient status and one child with septic shock requiring urgent surgery. Conclusion: The results suggest that intravenous triple antibiotic therapy alone is an efficacious first-line treatment in children developing intra-abdominal abscesses following appendectomy. Surgical intervention is rarely necessary except in patients with an alarming patient status or with signs of septic shock.
引用
收藏
页码:104 / 109
页数:6
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