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Aziz et al. Mini-invasive Surg 2017;1:143-7 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2017.20
www.misjournal.net
Original Article Open Access

The role of delayed laparoscopic suction

for intra-abdominal collection or abscess

post appendectomy in paediatric patients:

case series and review of literature

Dayang Anita Abdul Aziz , Surita Said , Marjmin Osman , Felicia Lim , Mahmud Mohd Nor , Faizah Mohd Zaki ,
1
1
1
1
3
2
Zarina Abdul Latiff 4
1 Paediatric Surgery Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Jalan Yaacob Latiff, Cheras, Kuala
Lumpur 56000, Malaysia.
2 Department of Anaesthesia, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Jalan Yaacob Latiff, Cheras, Kuala Lumpur 56000, Malaysia.
3 Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Jalan Yaacob Latiff, Cheras, Kuala Lumpur 56000, Malaysia.
4 Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Jalan Yaacob Latiff, Cheras, Kuala Lumpur 56000, Malaysia.
Correspondence to: Prof. Dayang Anita Abdul Aziz, Paediatric Surgery Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre
(UKMMC), Jalan Yaacob Latiff, Cheras, Kuala Lumpur 56000, Malaysia. E-mail: dayanganita@yahoo.co.uk
How to cite this article: Aziz DAA, Said S, Osman M, Lim F, Mohd Nor M, Mohd Zaki F, Latiff ZA. The role of delayed laparoscopic suction for
intra-abdominal collection or abscess post appendectomy in paediatric patients: case series and review of literature. Mini-invasive Surg 2017;1:143-7.

ABSTRACT
Article history: Aim: Intra-abdominal collection or abscess (IAA) is a dreaded complication post open or
Received: 8 Jun 2017 laparoscopic appendectomy for perforated appendicitis. There have been many discussions on
Accepted: 15 Aug 2017 the role of laparoscopic irrigation during laparoscopic appendectomy for perforated appendix
Published: 30 Sep 2017 but not its role for patients who subsequently developed IAA post-surgery. Methods: All patients
who developed clinical symptoms and radiological evidence of IAA of more than 5 cm × 5 cm
Key words: post appendectomy from January 2014 to May 2016 were subjected to delayed laparoscopic
Intraabdominal abscess, suction (DLS) of the IAA. Days to resolution of fever and improvement of symptoms post the
appendicitis, DLS were recorded. Complications during DLS like bowel injury, bleeding and conversion to
laparoscopic, open surgery were documented and analysed. Patients were followed up for 1 month to a year to
paediatrics look for potential adhesive intestinal obstruction. Results: Seven patients who met the criteria
of large IAA were subjected to DLS at post-operative day 3 to day 5 post appendectomy. Six
of the cases were post laparoscopic appendectomy and one case was post open appendectomy
from another institution. Ports were inserted via the same sites as used during the first surgery.
Turbid intraperitoneal fluid and abscesses were laparoscopically sucked without irrigation.
There was no bowel injury, bleeding or conversion in any of the cases. All patients were afebrile
within 24 h post procedure and their associated symptoms improved significantly. All patients
were discharged within three days of DLS and have not returned with adhesive obstruction.
Conclusion: Early recognition of IAA is important and early attempt at DLS resulted in better
outcome of patients and lesser hospital stay. DLS is a safe and feasible technique.

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