Complications associated with appendicitis

Abstract

I N a discussion of postoperative comphcations CutIer and Scott’ state that, “With the period that fohows operative intervention begin the triaIs and tribuIations of the surgeon.” This statement is probably nowhere more true than in the case of those patients who require surgical attention because of a septic appendix, and in whom infection has extended beyond the confines of this organ. It is a we11 known fact that today the mortaIity of appendectomy for uncomplicated acute appendicitis is almost neghgibIe, whereas in the more advanced cases, when peritonitis of some degree has supervened, the mortaIity continues to be disturbingIy high. For the most part, deaths from acute appendicitis are due to some phase of peritonitis either directIy, as from toxemia, severe sepsis and iIeus, or indirectIy from the Iater compIications of peritonitis, e.g., intestina1 obstruction, empyema, pneumonia, etc. If one consuIts the records of the surgical cIinic in any Iarge hospita1, the more serious complications of acute appendicitis wiII be found to incIude genera1 peritonitis, residua1 or secondary abscesses, intestinal obstruction, major wound sepsis, pneumonia, pyIephIebitis, Iiver abscess, empyema, puImonary embohsm, feca1 fistuIa, postoperative hemorrhage and thrombophIebitis. The present discussion is concerned with the abdomina1 comphcations encountered in the management of the perforated appendix and, in particuIar, with those which occur foIIowing operative intervention.