Skip to main content
SpringerLink
Log in

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

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Hale DA, Molloy M, Pearl RH et al (1997) Appendectomy: a contemporary appraisal. Ann Surg 225:252–261

    Article  PubMed  CAS  Google Scholar 

  2. Kokoska ER, Silen ML, Tracy TF Jr et al (1998) Perforated appendicitis in children: risk factors for the development of complications. Surgery 124:619–625

    Article  PubMed  CAS  Google Scholar 

  3. Fulcher AS, Turner MA (1996) Percutaneous drainage of enteric-related abscesses. Gastroenterologist 4:276–285

    PubMed  CAS  Google Scholar 

  4. Jamieson DH, Chait PG, Filler R (1997) Interventional drainage of appendiceal abscesses in children. AJR 169:1619–1622

    PubMed  CAS  Google Scholar 

  5. vanSonnenberg E, Wittich GR, Casola G et al (1987) Periappendiceal abscesses: percutaneous drainage. Radiology 163:23–26

    PubMed  CAS  Google Scholar 

  6. 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 40:1612–1615

    Article  PubMed  Google Scholar 

  7. Piskun G, Kozik D, Rajpal S et al (2001) Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis. Surg Endosc 15:660–662

    Article  PubMed  CAS  Google Scholar 

  8. Horwitz JR, Custer MD, May BH et al (1997) Should laparoscopic appendectomy be avoided for complicated appendicitis in children? J Pediatr Surg 32:1601–1603

    Article  PubMed  CAS  Google Scholar 

  9. Oliak D, Yamini D, Udani VM et al (2001) Initial nonoperative management of periappendiceal abscess. Dis Colon Rectum 44:936–941

    Article  PubMed  CAS  Google Scholar 

  10. Brown CV, Abrishami M, Muller M et al (2003) Appendiceal abscess: immediate operation or percutaneous drainage? Am Surg 69:829–832

    PubMed  Google Scholar 

  11. Doberneck RC, Mittelman J (1982) Reappraisal of the problems of intra-abdominal abscess. Surg Gynecol Obstet 154:875–879

    PubMed  CAS  Google Scholar 

  12. 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) 5:349–356

    Article  Google Scholar 

  13. 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 26:874–878

    Article  PubMed  CAS  Google Scholar 

  14. Pereira JK, Chait PG, Miller SF (1996) Deep pelvic abscesses in children: transrectal drainage under radiological guidance. Radiology 198:393–396

    PubMed  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Sanjay Maroo

    Present address: Department of Radiology, Royal Hospital for Sick Children, Glasgow, UK

Authors and Affiliations

  1. Image Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, M5G 1X8, Ontario, Canada

    Jeffrey W. McCann, Ganesh Krishnamurthy & Bairbre L. Connolly

  2. Department of Surgery, The Hospital for Sick Children, Toronto, Canada

    Paul Wales

  3. Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada

    Sanjay Maroo, Joao G. Amaral, Dimitri Parra, Michael Temple & Philip John

Authors
  1. Jeffrey W. McCann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sanjay Maroo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paul Wales
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joao G. Amaral
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ganesh Krishnamurthy
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dimitri Parra
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michael Temple
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Philip John
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Bairbre L. Connolly
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jeffrey W. McCann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

McCann, J.W., Maroo, S., Wales, P. et al. Image-guided drainage of multiple intraabdominal abscesses in children with perforated appendicitis: an alternative to laparotomy. Pediatr Radiol 38, 661–668 (2008). https://doi.org/10.1007/s00247-008-0816-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-008-0816-y

Keywords

Search

Navigation