Abstract
Purpose: For patients of acute appendicitis with abscess formation initially treated conservatively, the role of interval appendectomy is controversial in infants. We retrospectively studied the clinical course based on the operative and histopathological findings of infantile patients to evaluate the role of interval appendectomy.
Methods: A retrospective chart review was performed in 29 patients who presented with acute appendicitis with abscess formation, and were treated by initial nonoperative management followed by interval appendectomy between April 2004 and February 2012.
Results: The clinical profiles of 29 patients were as followed: the mean age was 8.2 ± 3.3 years (average + S.D.), mean duration of symptoms registered 7.1 ± 3.5 days, mean hospitalization time for initial nonoperative management was 13.2 ± 5.0 days, mean time interval between initial antibiotics therapy and operation was 114.9 ± 26.6 days, mean time of total hospitalization recorded 22.1 ± 5.6 days, and mean operation time scored 96.9 ± 55.1 minutes. Complications in the clinical course such as surgical site infection, abscess formation in abdomen after operation and ileus were not found in these cases. The narrowed inner lumen of excised appendices was found in 48.2% of the cases. Evidence of inflammation was present in 51.7% of the cases by histological examination.
Conclusions: Pathological findings, such as focal inflammations and narrowed lumen of the appendix, were found in about half of the cases in our study. These findings support the concept that interval appendectomy could be recommended in infantile acute appendicitis with a high risk of relapse.
