I was wanting to solicit the group regarding your experience in the management
of perforated appendicitis. Are patients taken to the OR expeditiously or do
your surgeons manage these patients nonoperatively with IV antibiotics with
delayed appendectomy? I recently listened to a Pediatric Audiodigest lecture in
which this topic was addressed and the speaker, a surgeon (Dr. Adolph from
Oschner Clinic in New Orleans) recommended initial medical management with
delayed appendectomy due to a lower complication rate in those with delayed vs.
immediate surgical intervention (12% vs 20% complication rate). I have seen
patients being managed both ways and was curious how other centers manage these
Amy Johnson, M.D.
Rocky Mountain Hospital for Children
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