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    Periappendicular Infiltrate

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    Riz Sanfebrian Adiatma
    Periappendicular infiltrate describes the management of appendiceal masses through conservative treatment with antibiotics and intravenous fluids. Initial treatment involves broad-spectrum antibiotics and fluids until the inflammatory mass resolves. Some patients then undergo interval appendicectomy after symptoms improve, while others adopt a semi-conservative or entirely conservative approach without surgery. For those that improve, interval surgery is indicated 8 to 12 weeks later if needed. Antibiotic regimens include second-generation cephalosporins with metronidazole or alternative single agents. Pain is controlled through NSAIDs, morphine, or paracetamol. Patients are restricted from oral intake for 12-48 hours or allowed diet as tolerated.

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    Periappendicular Infiltrate

    Uploaded by

    Riz Sanfebrian Adiatma
    92 views5 pages
    Periappendicular infiltrate describes the management of appendiceal masses through conservative treatment with antibiotics and intravenous fluids. Initial treatment involves broad-spectrum antibiotics and fluids until the inflammatory mass resolves. Some patients then undergo interval appendicectomy after symptoms improve, while others adopt a semi-conservative or entirely conservative approach without surgery. For those that improve, interval surgery is indicated 8 to 12 weeks later if needed. Antibiotic regimens include second-generation cephalosporins with metronidazole or alternative single agents. Pain is controlled through NSAIDs, morphine, or paracetamol. Patients are restricted from oral intake for 12-48 hours or allowed diet as tolerated.

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    Periappendicular infiltrate

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    Periappendicular infiltrate describes the management of appendiceal masses through conservative treatment with antibiotics and intravenous fluids. Initial treatment involves broad-spectrum antibiotics and fluids until the inflammatory mass resolves. Some patients then undergo interval appendicectomy after symptoms improve, while others adopt a semi-conservative or entirely conservative approach without surgery. For those that improve, interval surgery is indicated 8 to 12 weeks later if needed. Antibiotic regimens include second-generation cephalosporins with metronidazole or alternative single agents. Pain is controlled through NSAIDs, morphine, or paracetamol. Patients are restricted from oral intake for 12-48 hours or allowed diet as tolerated.

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    © All Rights Reserved
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    92 views5 pages

    Periappendicular Infiltrate

    Uploaded by

    Riz Sanfebrian Adiatma
    Periappendicular infiltrate describes the management of appendiceal masses through conservative treatment with antibiotics and intravenous fluids. Initial treatment involves broad-spectrum antibiotics and fluids until the inflammatory mass resolves. Some patients then undergo interval appendicectomy after symptoms improve, while others adopt a semi-conservative or entirely conservative approach without surgery. For those that improve, interval surgery is indicated 8 to 12 weeks later if needed. Antibiotic regimens include second-generation cephalosporins with metronidazole or alternative single agents. Pain is controlled through NSAIDs, morphine, or paracetamol. Patients are restricted from oral intake for 12-48 hours or allowed diet as tolerated.

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    © All Rights Reserved
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    Periappendicular infiltrate

    Introduction
    An appendiceal mass is the end result of a walled-off appendiceal perforation and
    represents a pathological spectrum ranging from phlegmon toabscess.1,2 'Classical
    management' involves initial conservative management with broad-spectrum antibiotics
    and intravenous fluid until the inflammatory mass resolves. Patients are offered interval
    appendicectomy following resolution of symptoms. More recently, the need for interval
    appendicectomy has been questioned, with a number of authors adopting semi
    conservative approach with immediate appendicectomy or entirely conservative approach
    without intervalappendicectomy.4-6. In case of improvement in the patient's condition,
    interval surgery is indicated after 8 to 12 weeks.
    US or computed tomography-guided percutaneous drainage is indicated

    Management
    Antibiotic
    Initial parenteral antibiotic regimens used included a second- or third-generation
    cephalosporin (e.g., cefmetazole, cefotaxime, or ceftriaxone) plus metronidazole (or
    tinidazole) or single-agent regimens of amoxicillin-clavulanate (or ampicillin-sulbactam),
    piperacillin-tazobactam, or a carbapenem (ertapenem or meropenem). Oral (and alternative
    parenteral) regimens, started upon hospital discharge, included a fluoroquinolone or an
    advanced generation cephalosporin plus metronidazole, and amoxicillin-clavulanate. Four
    trials (12%) used intravenous and oral amoxicillin-clavulanate (or ampicillin-sulbactam).
    Pain Control
    Three trials (9%) used a nonsteroidal anti-inflammatory drug (NSAID), 6,22,29 diclofenac, as a
    scheduled regimen, two (6%) used morphine4,20 and one (3%) an unspecified narcotic40 as
    needed, and one (3%) used paracetamol and dextropropoxyphene for outpatients. 4
    Diet
    Participants were prohibited oral intake 12 hours in two studies (6%),12,18 24 hours in nine
    studies (26%),5,7,10,25,27,28,34,37,43 and 48 hours in one study (3%),33 and allowed diet as tolerated
    in seven (21%; four pediatric and three adults trials)11,20,21,23,26,32,40; diet was unspecified in 15
    studies (44%).

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