Laparoscopic Interval Appendectomy for Perforated Appendicitis

Brent Matthews, MD, FACS; Sean Glasgow, MD; Richard Pierce, MD, PhD; Jennifer Spitler, MD; Margaret Frisella, RN

Product Details
Product ID: ACS-2505
Year Produced: 2006
Length: 8 min.


Lapararoscopic and open appendectomy for perforated appendicitis is associated with an increased risk of postoperative complications compared to appendectomy for noncomplicated appendicitis. Interval appendectomy is frequently performed in patients with a periappendiceal mass who improve with broad-spectrum antibiotics with or without percutaneous catheter drainage. This video demonstrates a laparoscopic interval appendectomy for perforated. 31 year old male presented to the emergency room with 5 days of right lower quadrant abdominal pain. An abdominal/pelvic CT scan demonstrated perforated appendicitis and abscess. The patient underwent percutaneous drainage of the abscess. Four weeks following drainage of the intra-abdominal abscess, a fisutogram and CT scan were performed. The abscess had resolved and the catheter was removed. A laparoscopic interval appendectomy was scheduled 6 weeks after initial presentation. The patient underwent laparoscopic interval appendectomy and drain placement. Pathology demonstrated acute appendicitis, necrosis and an impacted fecalith. The patient was discharged home on postoperative day one. The drain was removed on postoperative day seven. He continues to recover uneventfully at one month follow-up. Minimally invasive surgery is an appropriate alternative in patients requiring an interval appendectomy.