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Interventional Radiology as a Therapeutic Option for Complicated Appendicitis

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Controversies in Pediatric Appendicitis

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Abstract

Percutaneous drainage of abdominal abscesses has become a frequently used and valuable alternative to open surgical intervention, with similar outcomes in clinical improvement and lower morbidity and mortality. The percutaneous approach is well tolerated and less invasive to surgical drainage. Multiple modalities, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), can be used to diagnose, locate, and define abscess, while ultrasound and CT are the most common imaging modalities used to guide drain placement. Herein, we discuss the current controversies with reference to interventional radiology in the management of appendicitis.

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References

  1. Hogan MJ. Appendiceal abscess drainage. Tech Vasc Interv Radiol. 2003;6(4):205–14.

    Article  PubMed  Google Scholar 

  2. Whyte C, Levin T, Harris BH. Early decisions in perforated appendicitis in children: lessons from a study of nonoperative management. J Pediatr Surg. 2008;43(8):1459–63.

    Article  PubMed  Google Scholar 

  3. Briddon CK III. Surgical observations in the treatment of the diseases and accidents of the liver. Ann Surg. 1885;2(7):51–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Towbin RB. Pediatric interventional procedures in the 1980s: a period of development, growth, and acceptance. Radiology. 1989;170(3 Pt 2):1081–90.

    Article  CAS  PubMed  Google Scholar 

  5. Mueller PR. The evolution of image-guided percutaneous abscess drainage: a short history. Semin Interv Radiol. 2003;20(3):171–6.

    Article  Google Scholar 

  6. Brolin RE, Nosher JL, Leiman S, et al. Percutaneous catheter versus open surgical drainage in the treatment of abdominal abscesses. Am Surg. 1984;50(2):102–8.

    CAS  PubMed  Google Scholar 

  7. Andersson RE, Petzold MG. Nonsurgical treatment of appendiceal abscess or phlegmon: a systematic review and meta-analysis. Ann Surg. 2007;246:741–8.

    Article  PubMed  Google Scholar 

  8. Maxfield MW, Schuster KM, Bokhari J, et al. Predictive factors for failure of nonoperative management in perforated appendicitis. J Trauma Acute Care Surg. 2014;76:976–81.

    Article  PubMed  Google Scholar 

  9. DiSaverio S, Birindelli A, Kelly MD, et al. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. World J Emerg Surg. 2016;11:34.

    Article  Google Scholar 

  10. Mazuski JE, Tessier JM, May AK, et al. The Surgical Infection Society revised guidelines on the management of intra-abdominal infection. Surg Infect. 2017;18:1–76.

    Article  Google Scholar 

  11. Dillman JR, Gadepalli S, Sroufe NS, et al. Equivocal pediatrix appendicitis: unenhanced MR imaging protocol for nonsedated children- a clinical effectiveness study. Radiology. 2016;279(1):216–25.

    Article  PubMed  Google Scholar 

  12. Brown C, Kang L, Kim ST. Percutaneous drainage of abdominal and pelvic abscesses in children. Semin Interv Radiol. 2012;29:286–94.

    Article  Google Scholar 

  13. Hogan MJ, Marshalleck FE, Sidhu MK, et al. Quality improvement guidelines for pediatric abscess and fluid drainage. J Vasc Interv Radiol. 2012;23:1397–402.

    Article  PubMed  Google Scholar 

  14. Thomas J, Turner SR, Nelson RC, Paulson EK. Postprocedure sepsis in imaging-guided percutaneous hepatic abscess drainage: how often does it occur? Am J Roentgenol. 2006;186(5):1419–22.

    Article  Google Scholar 

  15. Shuler FW, Newman CN, Angood PB, et al. Nonoperative management for intra-abdominal abscesses. Am Surg. 1996;62:218–22.

    CAS  PubMed  Google Scholar 

  16. Ciftci TT, Akinci D, Akhan O. Percutaneous transhepatic drainage of inaccessible postoperative abdominal abscesses. AJR Am J Roentgenol. 2012 Feb;198(2):477–81.

    Article  PubMed  Google Scholar 

  17. Ayyagari RR, Yeh C, Arici M, et al. Image-guided transvesicular drainage of pelvic fluid collections: a safe and effective alternative approach. J Vasc Interv Radiol. 2016;27(5):689–93.

    Article  PubMed  Google Scholar 

  18. Oliak D, Yamini D, Vm U, et al. Initial nonoperative management for periappendiceal abscess. Dis Colon Rectum. 2001;44:936–41.

    Article  CAS  PubMed  Google Scholar 

  19. Simillis C, Symeonides P, Shorthouse AJ, Tekkis PP. A meta-analysis comparing conservative treatment versus acute appendectomy for complicated appendicitis (abscess or phlegmon). Surgery. 2010;147:818–29.

    Article  PubMed  Google Scholar 

  20. Jeffrey RB, Federle MP, Tolentino CS. Periappendiceal inflammatory masses: CT-directed management and clinical outcome in 70 patients. Radiology. 1988;167(1):13–6.

    Article  PubMed  Google Scholar 

  21. Kerlan RK Jr, Jeffrey RB Jr, Pogany AC, Ring EJ. Abdominal abscesses with low-output fistula: successful percutaneous drainage. Radiology. 1985;155(1):73–5.

    Article  PubMed  Google Scholar 

  22. Krishnamoorthi R, Ramarajan N, Wang NE, et al. Effectiveness of a staged US and CT protocol for the diagnosis of pediatric appendicitis: reducing radiation exposure in the age of ALARA. Radiology. 2011;259(1):231–9.

    Article  PubMed  Google Scholar 

  23. Strauss K, Kaste SC. The ALARA (as low as reasonably achievable) concept in pediatric interventional and fluoroscopic imaging: striving to keep radiation doses as low as possible during fluoroscopy of pediatric patients – a white paper executive summary. Radiology. 2006;240(3):621–2.

    Article  PubMed  Google Scholar 

  24. Gervais DA, Brown SD, Connolly SA, et al. Percutaneous imaging-guided abdominal and pelvic abscess drainage in children. Radiographics. 2004;24(3):737–54.

    Article  PubMed  Google Scholar 

  25. Beland MD, Da G, Hahn PF, et al. CT-guided transgluteal drainage of deep pelvic abscesses: indicates, technique, procedure-related complications, and clinical outcome. Radiographics. 2002;22(6):1353–67.

    Article  Google Scholar 

  26. Rajak CL, Gupta S, Jain S, et al. Percutaneous treatment of liver abscesses: needle aspiration versus catheter drainage. AJR Am J Roentgenol. 1998;170(4):1035–9.

    Article  CAS  PubMed  Google Scholar 

  27. Hogan MJ, Hoffer FA. Biopsy and drainage techniques in children. Tech Vasc Interv Radiol. 2010;13(4):206–13.

    Article  PubMed  Google Scholar 

  28. vanSonnengerg E, Ferrucci JT Jr, Mueller PR, et al. Percutaneous drainage of abscesses and fluid collections: technique, results and applications. Radiology. 1982;142(1):1–10.

    Article  Google Scholar 

  29. Lorenz J, Thomas JL. Complications of percutaneous fluid drainage. Semin Interv Radiol. 2006;23:194–204.

    Article  Google Scholar 

  30. Heneghan JP, Everts RJ, Nelson RC. Multiple fluid collections: CT- or US-guided aspiration-evaluation of microbiologic results and implications for clinical practice. Radiology. 1999;212:669–72.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Departments of Surgery and Vascular and Interventional Radiology, Mott Children’s Hospital, University of Michigan, Ann Arbor, MI, USA

    Marcus Jarboe & Sara Smolinski-Zhao

Authors
  1. Marcus Jarboe
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  2. Sara Smolinski-Zhao
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Correspondence to Marcus Jarboe .

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Editors and Affiliations

  1. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Catherine J. Hunter

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Jarboe, M., Smolinski-Zhao, S. (2019). Interventional Radiology as a Therapeutic Option for Complicated Appendicitis. In: Hunter, C. (eds) Controversies in Pediatric Appendicitis. Springer, Cham. https://doi.org/10.1007/978-3-030-15006-8_9

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  • DOI: https://doi.org/10.1007/978-3-030-15006-8_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-15005-1

  • Online ISBN: 978-3-030-15006-8

  • eBook Packages: MedicineMedicine (R0)

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