What is the role of percutaneous drainage in the treatment of pediatric appendicitis?

Updated: Oct 25, 2018
  • Author: Adam C Alder, MD; Chief Editor: Carmen Cuffari, MD  more...
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Answer

Often, patients with gangrenous or perforated appendicitis develop intra-abdominal abscesses. [23] These may be present at the time of presentation or may develop after surgery or during hospitalization if an interval appendectomy is planned. Commonly, a patient who has a prolonged ileus or fever for more than 5 days postoperatively has an intra-abdominal abscess.

The usual approach is to perform a CT scan of the abdomen and pelvis with oral and intravenous contrast to define the presence of an abscess. If this study confirms the presence and accessibility of an abscess, percutaneous drainage should be performed.

A drain is commonly left in the abscess cavity, and continued drainage is monitored. Once drainage decreases, the drain can be removed. Repeat imaging is not always needed.


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