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Discrepancies Between Estimated and Expressed Abscess Volume in Pediatric Incision and Drainage.

Jeffrey T Neal1,2, Elizabeth M Waltman3, Andrew F Miller1,2

  • 1Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital.

Pediatric Emergency Care
|December 21, 2025
PubMed
Summary
This summary is machine-generated.

Discrepancies in estimating pediatric abscess volume occur with clinical or ultrasound methods. Combining both approaches significantly reduces errors, improving incision and drainage (I&D) decisions.

Keywords:
abscessincision & drainagepediatricpoint-of-care ultrasound

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Area of Science:

  • Pediatric Emergency Medicine
  • Medical Imaging
  • Surgical Procedures

Background:

  • Incision and drainage (I&D) is standard for pediatric abscesses.
  • Volume estimation discrepancies can lead to incorrect management.
  • Poor ultrasound or I&D technique may cause these discrepancies.

Purpose of the Study:

  • To determine the prevalence of volume discrepancies in pediatric abscesses during I&D.
  • To compare estimation accuracy between clinical and point-of-care ultrasound (POCUS) methods.
  • To evaluate the impact of combined assessment on discrepancy rates.

Main Methods:

  • Cross-sectional chart review of pediatric patients (≤21 years) undergoing I&D (2017-2023).
  • Abscess volumes estimated clinically and via POCUS.
  • Focused analysis on predicted volumes ≤1 mL (underestimated) and ≥10 mL (overestimated).
  • Discrepancies defined by specific volume thresholds.

Main Results:

  • 13.2% of sonographic and 7.6% of clinical estimates underestimated volume.
  • 2.3% of sonographic and 19.6% of clinical estimates overestimated volume.
  • Combined assessment reduced underestimation to 5.2% and overestimation to 1.2%.

Conclusions:

  • Combined clinical and POCUS assessment improves pediatric abscess volume prediction.
  • This integrated approach minimizes unnecessary procedures and missed I&D opportunities.
  • Accurate volume assessment is crucial for optimal pediatric abscess management.