Appendicular abscess natural history, complications and prognosis: Difference between revisions

Jump to navigation Jump to search
m (Bot: Removing from Primary care)
 
(5 intermediate revisions by 5 users not shown)
Line 3: Line 3:
{{CMG}};{{AE}}{{ADG}}
{{CMG}};{{AE}}{{ADG}}
==Overview==
==Overview==
Without treatment, the patient with appendicular abscess will likely develop symptoms of  diffuse abdominal [[pain]], which is different from typical appendicitis [[pain]], starting centrally (in the periumbilical region) before localizing to the [[right iliac fossa]] in the right lower quadrant of the [[abdomen]]. During the final stage of the untreated disease process, the appendix will rupture, and this may eventually lead to death if [[peritonitis]] develops.<ref> Appendicitis. Wikipedia (2016). http://schools-wikipedia.org/wp/a/Appendicitis.htm Accessed on February 4, 2016</ref>. Complications that can develop as a result of the untreated appendicular abscess include:[[septicemia]], [[rupture]], [[peritonitis]], [[hemorrhage]] and death. Prognosis of the abscess is good with [[antibiotics]] and [[percutaneous]] drain and resolves without the need for appendectomy,but it is recommended to follow and appendicular abscess by interval appendectomy after 8-12 weeks to prevent recurrence.
Without treatment, the patient with [[appendicular]] [[abscess]] will likely develop symptoms of  diffuse [[abdominal pain]], which is different from typical [[appendicitis]] [[pain]], starting centrally (in the periumbilical region) before localizing to the [[right iliac fossa]] in the right lower quadrant of the [[abdomen]]. During the final stage of the untreated disease process, the [[appendix]] will [[rupture]], and this may eventually lead to death if [[peritonitis]] develops.<ref> Appendicitis. Wikipedia (2016). http://schools-wikipedia.org/wp/a/Appendicitis.htm Accessed on February 4, 2016</ref> Complications that can develop as a result of the untreated appendicular abscess include: [[septicemia]], [[rupture]], [[peritonitis]], [[hemorrhage]] and death. Prognosis of the abscess is good with [[antibiotics]] and [[percutaneous]] drain and resolves without the need for appendectomy,but it is recommended to follow and appendicular abscess by interval appendectomy after 8-12 weeks to prevent recurrence.


==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==
===Natural history===
===Natural History===
*The symptoms of appendicular abscess typically develop when the inflamed appendix gets complicated due to decreased blood flow.  
*The symptoms of appendicular abscess typically develop when the [[inflamed]] [[appendix]] gets complicated due to decreased [[blood flow]].  
*Without treatment, the patient will likely develop symptoms of  diffuse abdominal [[pain]], which is different from typical appendicitis [[pain]], starting centrally (in the periumbilical region) before localizing to the [[right iliac fossa]] in the right lower quadrant of the [[abdomen]].
*Without treatment, the patient will likely develop symptoms of  diffuse [[abdominal pain]], which is different from typical [[appendicitis]] [[pain]], starting centrally (in the periumbilical region) before localizing to the [[right iliac fossa]] in the right lower quadrant of the [[abdomen]].
*They will also experience [[loss of appetite]], [[diarrhea]], high grade[[fever]], [[nauseua]], and [[vomiting]].  
*They will also experience [[loss of appetite]], [[diarrhea]], high grade [[fever]], [[Nausea and vomiting|nausea and vomiting.]]   
*During the final stage of the untreated disease process, the appendix will rupture, and this may eventually lead to death if [[peritonitis]] develops.<ref> Appendicitis. Wikipedia (2016). http://schools-wikipedia.org/wp/a/Appendicitis.htm Accessed on February 4, 2016</ref>
*During the final stage of the untreated [[disease]] process, the [[appendix]] will [[rupture]], and this may eventually lead to death if [[peritonitis]] develops.<ref> Appendicitis. Wikipedia (2016). http://schools-wikipedia.org/wp/a/Appendicitis.htm Accessed on February 4, 2016</ref>


===Complications===
===Complications===
Line 18: Line 18:
*[[Peritonitis]]  
*[[Peritonitis]]  
*[[Hemorrhage]]
*[[Hemorrhage]]
*Death


===Prognosis===
===Prognosis===
*Most patients with appendicular abscess recover quickly with drain and IV [[antibiotics]], but complications can occur if treatment is delayed or if [[peritonitis]] occurs.<ref name="PhamSullins2016">{{cite journal|last1=Pham|first1=Xuan-Binh D.|last2=Sullins|first2=Veronica F.|last3=Kim|first3=Dennis Y.|last4=Range|first4=Blake|last5=Kaji|first5=Amy H.|last6=de Virgilio|first6=Christian M.|last7=Lee|first7=Steven L.|title=Factors predictive of complicated appendicitis in children|journal=Journal of Surgical Research|volume=206|issue=1|year=2016|pages=62–66|issn=00224804|doi=10.1016/j.jss.2016.07.023}}</ref><ref name="pmid17856727">{{cite journal |vauthors=Pattison AC |title=FACTORS IN THE MORTALITY OF ACUTE APPENDICITIS |journal=Ann. Surg. |volume=103 |issue=3 |pages=362–74 |year=1936 |pmid=17856727 |pmc=1391035 |doi= |url=}}</ref>
*Majority of the patients with [[appendicular]] [[abscess]] recover quickly with drain and IV [[antibiotics]], but complications can occur if treatment is delayed or if [[peritonitis]] occurs.<ref name="PhamSullins2016">{{cite journal|last1=Pham|first1=Xuan-Binh D.|last2=Sullins|first2=Veronica F.|last3=Kim|first3=Dennis Y.|last4=Range|first4=Blake|last5=Kaji|first5=Amy H.|last6=de Virgilio|first6=Christian M.|last7=Lee|first7=Steven L.|title=Factors predictive of complicated appendicitis in children|journal=Journal of Surgical Research|volume=206|issue=1|year=2016|pages=62–66|issn=00224804|doi=10.1016/j.jss.2016.07.023}}</ref><ref name="pmid17856727">{{cite journal |vauthors=Pattison AC |title=FACTORS IN THE MORTALITY OF ACUTE APPENDICITIS |journal=Ann. Surg. |volume=103 |issue=3 |pages=362–74 |year=1936 |pmid=17856727 |pmc=1391035 |doi= |url=}}</ref>
 
*It usually takes between 10 and 28 days to recover completely.  
*It usually takes between 10 and 28 days to recover completely.  
*Typical Abscess responds quickly to [[antibiotics]] and [[percutaneous]] drain and resolves spontaneously.
*Typical abscess responds quickly to [[antibiotics]] and [[percutaneous]] drain and resolves spontaneously.
*If abscess resolves, [[Appendectomy|interval appendectomy]] should be performed 8-12 weeks after to prevent recurrent episodes.
*If abscess resolves, [[Appendectomy|interval appendectomy]] should be performed 8-12 weeks after to prevent recurrent episodes.
*Atypical presentation(when the patient presents with [[fever]], [[abdominal pain]] not typical to appendicitis, [[diarrhea]]) is more difficult to diagnose and is more apt to be complicated.
*Atypical presentation (when the patient presents with [[fever]], [[abdominal pain]] not typical to appendicitis, [[diarrhea]]) is more difficult to diagnose and is more apt to be complicated.
*In such condition prompt diagnosis, and treatment with [[Appendectomy|emergent appendectomy]] yield the best results with full recovery usually occurring in two to four weeks.
*In such condition prompt diagnosis, and treatment with [[Appendectomy|emergent appendectomy]] yield the best results with full recovery usually occurring in two to four weeks.
*[[Mortality]]  of appendicular abscess is very low < 0.2-0.8% but do occur in some cases, especially if [[peritonitis]] develops and is left untreated.<ref name="wiki1"> Appendicitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Appendicitis#Clinical Accessed on February 4, 2016</ref>
*[[Mortality]]  of appendicular abscess is very low < 0.2-0.8% but do occur in some cases, especially if [[peritonitis]] develops and is left untreated.<ref name="wiki1"> Appendicitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Appendicitis#Clinical Accessed on February 4, 2016</ref>
Line 32: Line 30:
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Gastroenterology]]
[[Category:Surgery]]

Latest revision as of 20:28, 29 July 2020

Abscess Main Page

Appendicular abscess Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Appendicular abscess from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Abdominal X Ray

CT

MRI

Echocardiography or Ultrasound

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Appendicular abscess natural history, complications and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Appendicular abscess natural history, complications and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Appendicular abscess natural history, complications and prognosis

CDC on Appendicular abscess natural history, complications and prognosis

Appendicular abscess natural history, complications and prognosis in the news

Blogs on Appendicular abscess natural history, complications and prognosis

Directions to Hospitals Treating Blastomycosis

Risk calculators and risk factors for Appendicular abscess natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Without treatment, the patient with appendicular abscess will likely develop symptoms of diffuse abdominal pain, which is different from typical appendicitis pain, starting centrally (in the periumbilical region) before localizing to the right iliac fossa in the right lower quadrant of the abdomen. During the final stage of the untreated disease process, the appendix will rupture, and this may eventually lead to death if peritonitis develops.[1] Complications that can develop as a result of the untreated appendicular abscess include: septicemia, rupture, peritonitis, hemorrhage and death. Prognosis of the abscess is good with antibiotics and percutaneous drain and resolves without the need for appendectomy,but it is recommended to follow and appendicular abscess by interval appendectomy after 8-12 weeks to prevent recurrence.

Natural History, Complications, and Prognosis

Natural History

Complications

Complications that can develop as a result of the untreated appendicular abscess include:

Prognosis

  • Majority of the patients with appendicular abscess recover quickly with drain and IV antibiotics, but complications can occur if treatment is delayed or if peritonitis occurs.[3][4]
  • It usually takes between 10 and 28 days to recover completely.
  • Typical abscess responds quickly to antibiotics and percutaneous drain and resolves spontaneously.
  • If abscess resolves, interval appendectomy should be performed 8-12 weeks after to prevent recurrent episodes.
  • Atypical presentation (when the patient presents with fever, abdominal pain not typical to appendicitis, diarrhea) is more difficult to diagnose and is more apt to be complicated.
  • In such condition prompt diagnosis, and treatment with emergent appendectomy yield the best results with full recovery usually occurring in two to four weeks.
  • Mortality of appendicular abscess is very low < 0.2-0.8% but do occur in some cases, especially if peritonitis develops and is left untreated.[5]

References

  1. Appendicitis. Wikipedia (2016). http://schools-wikipedia.org/wp/a/Appendicitis.htm Accessed on February 4, 2016
  2. Appendicitis. Wikipedia (2016). http://schools-wikipedia.org/wp/a/Appendicitis.htm Accessed on February 4, 2016
  3. Pham, Xuan-Binh D.; Sullins, Veronica F.; Kim, Dennis Y.; Range, Blake; Kaji, Amy H.; de Virgilio, Christian M.; Lee, Steven L. (2016). "Factors predictive of complicated appendicitis in children". Journal of Surgical Research. 206 (1): 62–66. doi:10.1016/j.jss.2016.07.023. ISSN 0022-4804.
  4. Pattison AC (1936). "FACTORS IN THE MORTALITY OF ACUTE APPENDICITIS". Ann. Surg. 103 (3): 362–74. PMC 1391035. PMID 17856727.
  5. Appendicitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Appendicitis#Clinical Accessed on February 4, 2016