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Percutaneous drainage of intra-abdominal abscess in children with perforated appendicitis

Michael F McNeeley1, Nghia Jack Vo, Somnath J Prabhu

  • 1Department of Radiology, University of Washington, Seattle Children's Hospital, Seattle, WA, USA. mcneeley@u.washington.edu

Pediatric Radiology
|January 17, 2012
PubMed

Insights

Percutaneous catheter drainage (PCD) effectively manages perforated appendicitis in children, postponing surgery. Large, diffuse abscesses increase risks of failure and recurrence, unlike localized ones.

Area of Science:

  • Pediatric Surgery
  • Interventional Radiology
  • Pediatric Gastroenterology

Background:

  • Surgical management of perforated appendicitis is debated.
  • Percutaneous catheter drainage (PCD) is increasingly used for periappendiceal abscess in stable children.

Purpose of the Study:

  • Evaluate the safety and effectiveness of PCD for perforated appendicitis in children.
  • Identify prognostic variables for PCD outcomes.

Main Methods:

  • Retrospective review of 33 children undergoing PCD for periappendiceal abscess (Oct 2006-Feb 2010).
  • Risk stratification based on preprocedural CT imaging features.

Main Results:

  • Appendectomy was successfully deferred in all cases.
  • Technical success rate was 87.9%; 3 recurrences and 1 complication (enterocutaneous fistula) occurred.
  • Large, diffuse abscesses correlated with higher technical failure rates (50%) compared to large, localized abscesses (P < 0.028).

Conclusions:

  • PCD is a viable option for managing pediatric perforated appendicitis.
  • Children with large, ill-defined abscesses face higher risks of complications and recurrence.
Abstract

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