Management of Post-appendectomy Abscesses in a Tertiary-care Children’s Hospital: a Retrospective Analysis

Abstract

Abstract Background Appendectomy is the most common surgical emergency that occurs in childhood and is typically performed to treat appendicitis. Nonetheless, postoperative complications remain common and the development of an intra-abdominal abscess is not an uncommon complication. Materials and Methods In this retrospective study, patient records of individuals under 18 years of age treated at our Pediatric Surgery Department for acute appendicitis and developed a post-operative abscess were examined. Examined data included demographic information and outcomes with particular attention to time at diagnosis of abscess after surgery, symptoms progression, biomarkers changes, abscess’ size, hospital length of stay, and treatment. Results Overall, thirteen children developed an abdominal post-appendectomy abscess as post-operative complication. Most patients had large-sized or multiple abscesses. The treatment was primarily performed with antibiotic therapy in the majority of cases, even though four patients required secondary surgical intervention. The success rate of the antibiotic treatment was about 70%, while that of the secondary surgical interventions was 100%. Median length of stay for patients experiencing post-operative complications was 7 days. Conclusions To improve the treatment of post-appendectomy abscesses in pediatric patients, implementing recent protocols for small and medium-sized abscesses should be considered. In addition, according to our experience, non-operative management can be initially attempted for large abscesses, followed by surgical drainage if no improvement is noted within 24–48 hours.