This protocol covers the clinically stable patient presenting with an appendicular abscess and no haemodynamic instability — a scenario where management diverges sharply from the unstable surgical emergency.
In the haemodynamically stable patient, appendicular abscess is approached non-operatively in the first instance: conservative treatment with intravenous antibiotics and, where appropriate, percutaneous drainage of the abscess. Immediate surgery is reserved for the unstable presentation.
When recurrent symptoms arise following initial conservative management, a surgical intervention is indicated. The structured protocol specifies how this procedure is selected, timed, and tailored to the individual patient — details that go beyond what can be summarised here.
DOI: 10.36346/sarjs.2024.v05i06.001
The treatment of an appendicular abscess can be divided into conservative treatment with intravenous antibiotics and percutaneous drainage of the abscess in stable patients.
For unstable patients an immediate appendectomy is performed followed by intra-venous antibiotics.
Interval appendectomy is no longer a routine and is only performed for patients who present with recurrent symptoms.
Interval appendectomy can be performed as an open or laparoscopic procedure.
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