Role of Peritoneal Irrigation in Laparoscopic Appendectomy Reduce Postoperative Intra-Abdominal Abscess Rates

We present a 19 year old female with 5 days of right-sided abdominal pain. A CT scan was obtained which demonstrated perforated appendicitis. The patient was taken to the operating theatre for diagnostic laparoscopy. Inspection revealed diffuse pus in all four quadrants of the abdomen. About 500 ml of pus was evacuated. A necrotic, perforated appendix was visualized and removed in the normal fashion. Irrigation with 3 liters of warm saline was performed, and a drain was left in place. Postoperatively, the patient was continued on intravenous antibiotics. However, laboratory studies demonstrated an uprising leukocytosis to 13.0 K/uL on postoperative day 5. Further imaging demonstrated multiple intra-abdominal abscesses Consultation with Interventional radiology led to placement of a pigtail catheter for transgluteal drainage. The patient was discharged home on oral antibiotics, with the catheter.