Skip to main content
Erschienen in: Pediatric Radiology 6/2008

01.06.2008 | Original Article

Image-guided drainage of multiple intraabdominal abscesses in children with perforated appendicitis: an alternative to laparotomy

verfasst von: Jeffrey W. McCann, Sanjay Maroo, Paul Wales, Joao G. Amaral, Ganesh Krishnamurthy, Dimitri Parra, Michael Temple, Philip John, Bairbre L. Connolly

Erschienen in: Pediatric Radiology | Ausgabe 6/2008

Einloggen, um Zugang zu erhalten

Abstract

Background

Appendicitis is the most common cause of an acute abdomen in children. With perforation, multiple intraperitoneal collections can be seen at presentation. In this situation, surgical treatment alone is rarely effective.

Objective

To determine the role of image-guided drainage in treating patients with acute appendicitis complicated by multiple intraabdominal collections.

Materials and methods

A retrospective review of patient charts and interventional radiology records was performed to identify all patients with acute complicated appendicitis treated by multiple image-guided drainage procedures. Data reviewed included the number of drainages and aspirations performed, drain dwell time, the clinical course and temperature profile, and the length of inpatient hospital stay and any complications experienced.

Results

The study population comprised 42 children with a mean age of 107.6 months. A total of 100 drainage catheters were inserted and 56 aspirations were performed. Of the 42 children, 24 were successfully treated at a single sitting, while 18 returned for further intervention. The mean drain dwell time was 8.18 days. The mean inpatient stay was 15.02 days. Treatment of the acute presentation with image-guided intervention was successful in 92.3% of children.

Conclusion

Successful management of acute perforated appendicitis with multiple intraabdominal abscesses can be achieved with multiple minimally invasive image-guided drainage procedures.
Literatur
1.
Zurück zum Zitat Hale DA, Molloy M, Pearl RH et al (1997) Appendectomy: a contemporary appraisal. Ann Surg 225:252–261PubMedCrossRef Hale DA, Molloy M, Pearl RH et al (1997) Appendectomy: a contemporary appraisal. Ann Surg 225:252–261PubMedCrossRef
2.
Zurück zum Zitat Kokoska ER, Silen ML, Tracy TF Jr et al (1998) Perforated appendicitis in children: risk factors for the development of complications. Surgery 124:619–625PubMedCrossRef Kokoska ER, Silen ML, Tracy TF Jr et al (1998) Perforated appendicitis in children: risk factors for the development of complications. Surgery 124:619–625PubMedCrossRef
3.
Zurück zum Zitat Fulcher AS, Turner MA (1996) Percutaneous drainage of enteric-related abscesses. Gastroenterologist 4:276–285PubMed Fulcher AS, Turner MA (1996) Percutaneous drainage of enteric-related abscesses. Gastroenterologist 4:276–285PubMed
4.
Zurück zum Zitat Jamieson DH, Chait PG, Filler R (1997) Interventional drainage of appendiceal abscesses in children. AJR 169:1619–1622PubMed Jamieson DH, Chait PG, Filler R (1997) Interventional drainage of appendiceal abscesses in children. AJR 169:1619–1622PubMed
5.
Zurück zum Zitat vanSonnenberg E, Wittich GR, Casola G et al (1987) Periappendiceal abscesses: percutaneous drainage. Radiology 163:23–26PubMed vanSonnenberg E, Wittich GR, Casola G et al (1987) Periappendiceal abscesses: percutaneous drainage. Radiology 163:23–26PubMed
6.
Zurück zum Zitat Ein SH, Langer JC, Daneman A (2005) Nonoperative management of pediatric ruptured appendix with inflammatory mass or abscess: presence of an appendicolith predicts recurrent appendicitis. J Pediatr Surg 40:1612–1615PubMedCrossRef Ein SH, Langer JC, Daneman A (2005) Nonoperative management of pediatric ruptured appendix with inflammatory mass or abscess: presence of an appendicolith predicts recurrent appendicitis. J Pediatr Surg 40:1612–1615PubMedCrossRef
7.
Zurück zum Zitat Piskun G, Kozik D, Rajpal S et al (2001) Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis. Surg Endosc 15:660–662PubMedCrossRef Piskun G, Kozik D, Rajpal S et al (2001) Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis. Surg Endosc 15:660–662PubMedCrossRef
8.
Zurück zum Zitat Horwitz JR, Custer MD, May BH et al (1997) Should laparoscopic appendectomy be avoided for complicated appendicitis in children? J Pediatr Surg 32:1601–1603PubMedCrossRef Horwitz JR, Custer MD, May BH et al (1997) Should laparoscopic appendectomy be avoided for complicated appendicitis in children? J Pediatr Surg 32:1601–1603PubMedCrossRef
9.
Zurück zum Zitat Oliak D, Yamini D, Udani VM et al (2001) Initial nonoperative management of periappendiceal abscess. Dis Colon Rectum 44:936–941PubMedCrossRef Oliak D, Yamini D, Udani VM et al (2001) Initial nonoperative management of periappendiceal abscess. Dis Colon Rectum 44:936–941PubMedCrossRef
10.
Zurück zum Zitat Brown CV, Abrishami M, Muller M et al (2003) Appendiceal abscess: immediate operation or percutaneous drainage? Am Surg 69:829–832PubMed Brown CV, Abrishami M, Muller M et al (2003) Appendiceal abscess: immediate operation or percutaneous drainage? Am Surg 69:829–832PubMed
11.
Zurück zum Zitat Doberneck RC, Mittelman J (1982) Reappraisal of the problems of intra-abdominal abscess. Surg Gynecol Obstet 154:875–879PubMed Doberneck RC, Mittelman J (1982) Reappraisal of the problems of intra-abdominal abscess. Surg Gynecol Obstet 154:875–879PubMed
12.
Zurück zum Zitat Nadler EP, Reblock KK, Vaughan KG et al (2004) Predictors of outcome for children with perforated appendicitis initially treated with non-operative management. Surg Infect (Larchmt) 5:349–356CrossRef Nadler EP, Reblock KK, Vaughan KG et al (2004) Predictors of outcome for children with perforated appendicitis initially treated with non-operative management. Surg Infect (Larchmt) 5:349–356CrossRef
13.
Zurück zum Zitat Chung T, Hoffer FA, Lund DP (1996) Transrectal drainage of deep pelvic abscesses in children using a combined transrectal sonographic and fluoroscopic guidance. Pediatr Radiol 26:874–878PubMedCrossRef Chung T, Hoffer FA, Lund DP (1996) Transrectal drainage of deep pelvic abscesses in children using a combined transrectal sonographic and fluoroscopic guidance. Pediatr Radiol 26:874–878PubMedCrossRef
14.
Zurück zum Zitat Pereira JK, Chait PG, Miller SF (1996) Deep pelvic abscesses in children: transrectal drainage under radiological guidance. Radiology 198:393–396PubMed Pereira JK, Chait PG, Miller SF (1996) Deep pelvic abscesses in children: transrectal drainage under radiological guidance. Radiology 198:393–396PubMed
Metadaten
Titel
Image-guided drainage of multiple intraabdominal abscesses in children with perforated appendicitis: an alternative to laparotomy
verfasst von
Jeffrey W. McCann
Sanjay Maroo
Paul Wales
Joao G. Amaral
Ganesh Krishnamurthy
Dimitri Parra
Michael Temple
Philip John
Bairbre L. Connolly
Publikationsdatum
01.06.2008
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 6/2008
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-008-0816-y

Weitere Artikel der Ausgabe 6/2008

Pediatric Radiology 6/2008 Zur Ausgabe

Hermes

Hermes

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.