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Is there a role for routine abdominal imaging in predicting postoperative intraabdominal abscess formation after

Sigmund H Ein1, Paul Wales, Jacob C Langer

  • 1The Division of General Surgery, Rm 1526, Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1X8. a_ein@istar.ca

Pediatric Surgery International
|January 12, 2008
PubMed

Insights

Routine abdominal imaging on postoperative day 5 did not improve prediction of intraabdominal abscess in pediatric patients after appendectomy for ruptured appendix. Clinical evaluation alone is sufficient for managing these patients.

Area of Science:

  • Pediatric Surgery
  • Abdominal Imaging
  • Infectious Disease

Background:

  • Appendectomy for ruptured appendix in children can lead to intraabdominal abscess.
  • Postoperative management aims to detect and treat complications early.

Purpose of the Study:

  • To evaluate the utility of routine abdominal imaging in predicting postoperative intraabdominal abscess after pediatric appendectomy for ruptured appendix.

Main Methods:

  • Retrospective review of 44 pediatric patients undergoing open appendectomy for ruptured appendix.
  • Patients received triple antibiotics for at least 5 days.
  • Postoperative day 5 assessment included clinical evaluation and imaging (ultrasound or CT).

Main Results:

  • 82% of patients were asymptomatic with fluid collections <5 cm on day 5 and required no further treatment.
  • 6% of these patients later developed symptomatic abscesses requiring treatment.
  • 18% of patients were symptomatic with abscesses >5 cm on day 5, requiring treatment.

Conclusions:

  • Routine abdominal imaging on postoperative day 5 does not enhance the prediction of intraabdominal abscess compared to clinical evaluation.
  • Clinical assessment appears adequate for managing pediatric patients post-appendectomy for ruptured appendix.

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