Abscess after appendicectomy in children: the role of conservative management

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. © 1998 British Journal of Surgery Society Ltd