Abscess after appendicectomy in children: the role of conservative management

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Abstract
Background: Intra-abdominal abscess remains a significant cause of morbidity following appendicectomy. In children, little emphasis has been placed on the non-invasive management of this complication using antibiotic therapy alone. This study reviews the experience of a paediatric surgical department in managing abscess arising after appendicectomy. Methods: Hospital records of all children undergoing appendicectomy between January 1992 and January 1997 were reviewed retrospectively. Results: Some 1024 children underwent appendicectomy over a 5-year period. Twenty three patients (2·2 per cent) developed abscesses after appendicectomy. Non-operative management with intravenous or oral antibiotics alone was successful in 21 patients, with complete clinical and radiological resolution of the abscess. Drainage of the septic collection was performed in only two patients: by laparotomy (n = 1) and by the transrectal route (n = 1). Conclusion: Antibiotic therapy alone is an efficacious and safe first-line treatment modality in children who develop this complication. Drainage of an abscess developing after appendicectomy is rarely necessary in children.