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Determinants of postoperative abscess occurrence and percutaneous drainage in children with perforated appendicitis

Sherif Emil1, Sherif Elkady, Layla Shbat

  • 1Division of Pediatric General and Thoracic Surgery, The Montreal Children's Hospital, 2300 Tupper, C-818, Montreal, QC, H3H 1P3, Canada, Sherif.Emil@McGill.ca.

Pediatric Surgery International
|November 3, 2014
PubMed

Insights

Risk factors for postoperative abscess after perforated appendicitis can be predicted. While percutaneous drainage led to longer hospital stays, it resulted in fewer readmissions for pediatric patients.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery
  • Infectious Disease Management

Background:

  • Postoperative abscesses following perforated appendicitis lack defined risk factors and clear indications for percutaneous drainage.
  • Understanding these factors is crucial for optimizing patient care and treatment strategies.

Purpose of the Study:

  • To identify risk factors associated with postoperative abscesses in children with perforated appendicitis.
  • To compare the outcomes of percutaneous drainage versus antibiotic treatment for these abscesses.

Main Methods:

  • A logistic regression model was employed to analyze data from 284 children over a 5-year period.
  • Risk factors for abscess development were identified, and outcomes of drainage versus non-drainage were compared.

Main Results:

  • Postoperative abscess occurred in 14.8% of patients. Significant risk factors included higher WBC count, bowel obstruction, diffuse peritonitis, and surgeon-specific factors.
  • Percutaneous drainage was associated with longer hospital stays (15.9 days) but fewer readmissions (9.5%) compared to non-drainage (12.2 days, 33.3% readmissions).
  • An increasing trend in percutaneous drainage use was observed without a corresponding increase in abscess occurrence.

Conclusions:

  • Specific clinical, surgical, and treatment-related factors can predict the risk of postoperative abscess.
  • Percutaneous drainage, while linked to extended hospital stays, demonstrated a trend towards reducing readmissions.
Abstract

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