Laparoscopic Drainage Versus Interventional Radiology In Management Of Appendicular Abscess :

access to caecum and remove any adhesions with surrounding by sharp \& blunt dissection , then access to appendicular abscess by sharp and blunt dissection after complete separation of the appendix from surrounding \& complete drainage of pus \& removal of all necrotic tissue , removal of the remnant appendix , in cases with healthy base of appendix ,we closed the stump with endo-loop , in case with unhealthy base , we closed the stump by suturing by ethibond 2/0 in two layers in case with little edema \& inflammation of caecum ( sutures not cut through ) , in cases with marked edema and inflammation of caecum , we close the site of base by omental patch fixed by taking full thickness sutures in wall of caecum and pass through omental patch , we examine any leak by pressing on caecum and observe any fecal matter comes \& air leak test , in all cases we put large drain at pelvis