This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (44)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Scott L. Samelson, MD; Hernan M. Reyes, MD

Arch Surg. 1987;122(6):691-696.

Abstract
• Of 522 children with acute appendicitis treated from 1978 to 1985, 170 had appendiceal perforation with peritonitis. The protocol for perforation included aggressive fluid resuscitation, preoperative triple antibiotic therapy, copious peritoneal lavage, avoidance of transperitoneal drains except those used for well-localized abscesses, delayed wound closure, and postoperative antibiotic therapy for seven to ten days. The minor complication rate was 22%; this included pleural effusion, wound infection, atelectasis, and prolonged ileus. The major complication rate was 3%; this included intra-abdominal abscess, gastrointestinal bleeding, wound dehiscence, pneumonia, and intestinal obstruction. Only four postoperative intra-abdominal abscesses occurred, in three patients. The mortality rate was zero. A comparison of this series with a similar group of 24 patients who underwent drainage showed the relative rate of abdominal abscess formation to be 1.8% (undrained) vs 12.5% (drained). We achieved our lowest rate of serious complications following surgery for pediatric perforated appendix with the use of aggressive fluid resuscitation, broad-spectrum antibiotic therapy, copious peritoneal irrigation, and delayed wound closure and without drainage.

(Arch Surg 1987;122:691-696)

Author Affiliations
From the Division of Pediatric Surgery, Department of Surgery, Cook County Hospital, University of Illinois College of Medicine, Chicago.

Footnotes
Accepted for publication Jan 9, 1987.

Read before the 94th Annual Meeting of the Western Surgical Association, Dearborn, Mich, Nov 17, 1986.

Reprint requests to Division of Pediatric Surgery, Cook County Hospital (B40), University of Illinois College of Medicine, 700 S Wood St, Chicago, IL 60612 (Dr Reyes).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Aminoglycoside-Based Triple-Antibiotic Therapy Versus Monotherapy for Children With Ruptured Appendicitis
Goldin et al.
Pediatrics 2007;119:905-911.
ABSTRACT | FULL TEXT  

Acute Appendicitis Risks of Complications: Age and Medicaid Insurance
Bratton et al.
Pediatrics 2000;106:75-78.
ABSTRACT | FULL TEXT  

Perforated or Gangrenous Appendicitis Treated With Aminoglycosides: How Do Bacterial Cultures Influence Management?
Dougherty et al.
Arch Surg 1989;124:1280-1283.
ABSTRACT