대한대장항문학회

This is a clinical analysis and review of one-hundred ninety-four patients with<br>periappendiceal abscesses who were treated at the Departmeat of Surgery,ㆍMasan<br>Samsung Hospital over a ten year period from January 1985 to December 1994. The<br>following results were obtained. The incidence of periappendiceal abscesses was 7.24%<br>of the total cases of appendicitis operated on during the same period, and most of the<br>patients(43.8%) were over fifty years old. The male to female ratio was 1:1.02. 41.2% of<br>the patients had operations within four days after their symptoms occurred. On<br>admission, the most common physical finding was tenderness on the right lower<br>quadrant of the abdomen (92.9%) and leukocytosis(≥ 10,000/mm<sup>3</sup>) was<br>noted on CBC in 82% of the patients. Abdominal sonograms revealed periappendiceal<br>abscesses in 88% of the patients, 83% were revealed with barium enema and 88% with<br>abdominal CT scan. Many patients(75.5%) visited the local clinic and were treated under<br>the diagnosis of gastritis or enteritis instead of appendicitis. One-hundred eighty-three<br>patients(94.3%) had appendectomies with drainages(94.3%), two patients had drainages of<br>abscesses without appendectomy, six patients had ileocecal resections and three patients<br>had right hemicolectomies. Microbiologically, E. coli was the most frequently cultured<br>species(63%) from abscess, and Klebsiella, Enterococcus and Proteus were isolated in<br>some cases. Postoperative complication occurred in seventy-five patients(38.6%) and the<br>most frequent complication was wound infection(28.8%). There was no mortality and the<br>mean hospital stay was fifteen days.<br>