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June 1979

Conservative Treatment of Appendiceal Peritonitis

Author Affiliations

New Orleans

Arch Surg. 1979;114(6):755. doi:10.1001/archsurg.1979.01370300109026

To the Editor.—The study by Drs Edward L. Bradley and James Isaacs entitled "Appendiceal Abscess Revisited" (Arch Surg 113:130-132, 1978) is well done and deserves commendation. However, I would like to emphasize that it was not J. B. Murphy who first advocated subsequent removal of the appendix after the conservative treatment of appendiceal peritonitis, but A. J. Ochsner, who originally advocated the conservative treatment of this condition.

The authors emphasize "the alarming number of complications" following drainage of an appendiceal abscess, although there was only one death in the 36 cases so treated. Of the 28 cases with complications, 18 (50%) resulted from the original infection. Ochsner and Percy in 19171 reported 55 cases similarly treated long before antibiotics were available, with 4 deaths (3.4%). Later this mortality was reduced to 2.2%. It must be emphasized that as undesirable as complications are, they are much better. As Murray

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