Interventional drainage of appendiceal abscesses in children.

Transrectal ultrasound and fluoroscopy-guided drainage of deep pelvic collections in children

“…In 1991, Gazelle et al [3] reported their experience on CT-guided TRD of pelvic abscesses in 10 patients, including 6 children aged between 3 and 17 years. In the first large series of deep pelvic abscess drainage in children, the technique consisted of combined transabdominal US and fluoroscopy guidance [7,8]. Pereira et al [7] described their experience in 26 patients.…”

“…They found the patients who underwent imaging-guided transrectal abscess drainage had a shorter hospital stay compared to those who underwent surgical drainage. In another report from the same institution [8], 25 TRD procedures were described using the same transabdominal guidance technique in the context of drainage of appendiceal abscesses in children. Chung et al [6] reported their experience in 7 children in whom they successfully drained deep pelvic abscesses using transrectal sonographic and fluoroscopic guidance.…”

“…Drainage of deep pelvic abscesses in children had traditionally been performed by the surgeons in the operating suite until image-guided drainage procedures were developed. Image-guided transrectal drainage (TRD) of deep pelvic abscesses became an established technique in the 1980s, initially in adults and subsequently in children [1][2][3][4][5][6][7][8].…”

“…Drainage methods included fluoroscopy guidance [1,4], abdominal ultrasound (US) guidance [2], computerized tomography (CT) guidance [3], combined abdominal US and fluoroscopy guidance [7,8], transrectal ultrasound (TRU) guidance [5], and combined TRU and fluoroscopy guidance [4,6]. The CT-guided transgluteal drainage of deep pelvic abscesses in children has also been reported [9], whereas transvaginal drainage is generally not practical in children.…”

The use of advanced imaging for appendicitis in children

“…Abscesses that can develop distant from the appendix may be obscured. Some surgeons [32] now favor percutaneous drainage of abscesses due to perforated appendicitis, and CT may be preferred in such cases to identify all abscess collections and to guide the drainage procedure.…”