Does Ruptured Appendicitis with Abscess Warrant Urgent Operative Intervention?

Abstract

Ruptured appendicitis with abscess formation occurs in up to 10% of patients with appendicitis. When interventional radiology (IR) is available, initial nonsurgical management with percutaneous drainage and IV antibiotics should be attempted, followed by interval appendectomy. Acute operative intervention may increase morbidity and should generally be reserved for patients with large ill-defined abscess, extraluminal appendicolith, and/or life-threatening peritonitis. It should also be considered when IR is unavailable.