Conservative treatment of intra-abdominal abscess in children.

Fifty-three children under 18 years of age with sonogram-proved intra-abdominal abscess (IAA) were seen between July 1993 and June 1996 at the Department of Pediatrics of the Mackay Memorial Hospital, then were studied retrospectively. Following a course of conservative treatment and follow-up with serial sonographic studies, 42 (79.3%) patients responded favourably to antibiotics treatment without drainage procedure. The other 11 patients' condition deteriorated, and surgical intervention was performed. The gradual shrinkage and completely resolved periods of the abscesses averaged 27.9 days. The average duration of antibiotic treatment was 23.6 days, intravenously for average 12.2 days followed by oral treatment until the abscess was completely resolved (average 11.4 days). The intra-abdominal abscess recurred in 3 (5.7%) patients. The experience demonstrates that pediatric patients with an intra-abdominal abscess must be followed closely by sonography, and they can be managed successfully with appropriate antibiotics alone. Surgical intervention is still needed if symptoms and signs persist or deteriorate.