Definition of Success Rate of Appendectomy without Peritoneal Lavage in Children with Generalized Appendicular Peritonitis

Abstract

Background: Peritonitis can be managed through local restoration, debridement during operation, lavage and a number of post-operative techniques such as drainage, continuous peritoneal lavage and re-operation in order to remove infective agents from the abdominal cavity as a way to prevent persistent peritonitis and sepsis. In this study, the results and complications caused by appendectomy without [diagnostic] peritoneal lavage in children with appendicular peritonitis were dealt with.Materials and Methods: A number of 30 children with the generalized peritonitis, a complication of perforated appendicitis, were studied. Fifty mg/kg ceftriaxone, 30 mg/kg metronidazole and sedatives were prescribed for all patients. Surgeries were performed by a single surgeon through making a small transverse incision in the right lower quadrant of the abdomen which included appendectomy and removing purulent discharges and debris collected around appendix without conducting peritoneal lavage. After surgery, the patients were examined in terms of incidence of complications, any more surgeries and treatment success for 6 weeks.Results: Five patients developed wound infection and three patients developed abdominal abscess. No early obstruction after surgery was seen. Peritonitis in all patients was controlled with appendectomy and antibiotic therapy and relaparotomy was not practiced for any patient.Conclusion: With regard to simplicity and high speed of appendectomy without cleansing peritoneum and its shorter incision and similar complications with other studies, and its considerable success to control the disease progress and unnecessary relaparotomy for the patients used this method, it seems that this method can be a good substitution for the conventional method of making long incision at midline of the abdomen and cleansing peritoneum.