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Laparoscopic appendectomy after appendicular phlegmon

P Saleg, MD A D'Urso, MD, PhD D Mutter, MD, PhD, FACS J Marescaux, MD, FACS, Hon FRCS, Hon FJSES, Hon FASA, Hon APSA
Epublication WebSurg.com, Jun 2017;17(06). URL: http://websurg.com/doi/vd01en4911

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Appendicitis is one of the main reasons for consultation and surgical interventions in the emergency departments around the world. If it is not diagnosed and treated timely, it can evolve towards an appendicular perforation, and as a result, it can become a peritonitis or an appendicular phlegmon. This latter case may occur in approximately 10% of cases. Currently, the management of the appendicular phlegmon is controversial. Some authors prefer to perform an appendectomy immediately, and others are in favor of medical treatment using antibiotic therapy and percutaneous drainage if possible and delay appendectomy. In this case, we present a patient presenting with an appendicular phlegmon in which a conservative management with percutaneous drainage and delayed surgery were decided upon.