Introduction: Appendiceal abscess remains a familiar problem in emergency surgical practice in Dakar, where some patients reach hospital only after several days of symptoms. Yet, few data describe how these patients are treated or how they fare in West African hospitals. We reviewed our experience at a tertiary referral centre, focusing on presentation, operative management, and early outcome.

Methods: We retrospectively reviewed patients aged 5 years or older who were operated on for an appendiceal abscess at Idrissa Pouye General Hospital between 1 January 2017 and 31 December 2024. Only abscesses confirmed at operation were retained. Demographic, clinical, laboratory, imaging, operative, and in-hospital outcome data were collected from the available records and analysed descriptively.

Results: Eighty-two patients were included; 54 (65.9%) were male. Mean age was 27.4 ± 12.8 years (range, 8-64 years). All patients had right iliac fossa pain, 68 (82.9%) had symptoms for more than 48 hours, and 54 (65.9%) had a palpable right iliac fossa mass. Ultrasonography identified an abscess in 39 of 44 patients examined (88.6%), whereas computed tomography identified an abscess in 46 of 48 patients examined (95.8%). All patients underwent open surgery. Drainage with appendicectomy was performed in 48 (58.5%), drainage alone in 26 (31.7%), and appendicectomy without separate drainage in 8 (9.8%). Six patients (7.3%) developed a postoperative complication, most commonly surgical-site infection (4/82; 4.9%). One patient required reoperation, and no in-hospital deaths occurred. Mean length of stay was 7.8 ± 3.5 days.

Conclusion: Most patients in this operative series were young, and delayed presentation was common. Open drainage, combined with appendicectomy whenever dissection was considered safe, resulted in few early complications and no in-hospital deaths. These results describe what was achievable in our setting; they do not settle the question of surgery versus initial non-operative treatment.