Management of appendiceal abscess. A 10-year experience in Central Saudi Arabia

OBJECTIVE: To study the outcome of patients with appendiceal abscess (AA) following immediate operative and non-operative management in terms of complications and hospital stay.

METHODS: Medical records of all adult patients treated for AA between July 2002 and June 2011 in the Department of Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia were reviewed. We identified 2 main groups of patients with the diagnosis of AA. The first group of patients were managed by CT-guided percutaneous drainage and parenteral antibiotics (non-operative management [NOM group]). The second group were patients who underwent surgical intervention (operative management [OM]). The outcome was determined in terms of complications, recurrence rate, and hospital stay.

RESULTS: Eighty AA patients were managed during the study period. Forty-two patients (52.5%) received NOM, while 38 patients (47.5%) underwent immediate OM. The complication rate was significantly higher in the OM group compared with the NOM group (44.7% versus 11.9%; p=0.0012). Successful NOM was achieved in 92.8% of patients. The overall mean hospital stay of the NOM group was 8.54±2.25, and the OM group was 10.86±4.32 days (p=0.003).

CONCLUSION: Non-operative management is associated with significantly lower complication rate and shorter hospital stay than OM.