If, in the course of an operation for appendicitis, a well walled-off collection of pus is found, it is a common practice to enter the abscess, even if it is rather large, and remove the appendix. This is, of course, done in the hope or belief that contamination of the general peritoneal cavity will not result. Unfortunately, in mesiocolic, procecal and many retrocecal and subhepatic abscesses, it is impossible to enter the intraperitoneal abscess and remove the appendix without breaking up the protective peritoneal adhesions. Unless the abscess is large or so superficially situated as to reach the mural peritoneum, in which case the abscess cavity can be freely explored and drained without fresh soiling of uncontaminated peritoneal surfaces, it will hardly be denied that the exercise of great caution in the removal of the pus, for example, by way of an extraperitoneal canal to prevent additional peritoneal contamination, conforms
EASTMAN JR. PREVENTION OF PERITONEAL CONTAMINATION IN DRAINAGE OF ABDOMINAL ABSCESSES. JAMA. 1923;80(12):833–835. doi:10.1001/jama.1923.02640390021007
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