Non surgical management of post appendectomy intraperitoneal abscesses

OBJECTIVES: to evaluate the effectiveness of non-surgical treatment of post appendectomy, abdominal abscesses in children at the Instituto Materno Infantil de Pernambuco, Recife, Brazil and to compare the results of two anti-microbial schemes (Cefoxitin versus Amikacin plus Metronidazole). METHODS: the study corresponds to the period from January 1997 to January 2000. There were 427 appendectomies performed in children during this period and 41 of them developed intra-abdominal abscesses. Thirty-nine were studied. The diagnosis of the abscesses was based on clinical signs, laboratorial tests and ultrasound examination. RESULTS: abscesses developed in 9,6% of the cases. Healing of the abscess occurred in 89,7% of the patients treated with the anti-microbial schemes. There was no difference between the effectiveness of the two anti-microbial schemes used. CONCLUSIONS: non-surgical treatment of post appendectomy intra-abdominal abscesses, based on anti-microbial endovenous therapy is safe, effective and without mortality. The anti-microbial schemes tested showed similar results. The Amikacin plus Metro-nidazole association is recomended.

Appendectomy; Amikacin; Cefoxitin; Metronidazole; Antibiotics

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