Abscess due to perforated appendicitis: factors associated with successful percutaneous drainage.
BACKGROUND
Percutaneous drainage is the standard treatment for perforated appendicitis with abscess. We studied factors associated with complete resolution (CR) with percutaneous drainage alone.


METHODS
Ninety-eight patients underwent percutaneous drainage for acute appendicitis complicated by abscess (October 1990 to September 2010). CR was defined as clinical recovery, resolution of the abscess on imaging, and drain removal without recurrence. Patients achieving CR were compared with patients not achieving CR.


RESULTS
The rate of CR was 78.6% (n = 77). Abscess grade was the only radiological factor associated with CR (P = .007). The CR rate was higher with transgluteal drainage (90.9% vs 79.2%) than with other anatomic approaches (P = .018) and higher with computed tomography-guided drainage than with ultrasound-guided drainage (82.7% vs 64.3%, P = .046).


CONCLUSIONS
CR was more likely to be achieved in patients with lower abscess grade, computed tomography-guided drainage, and a transgluteal approach.
Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge Street, Boston, MA, 02114, USA. Electronic address: pfagenholz@mgh.harvard.edu.
Peter J
PJ
Fagenholz
Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge Street, Boston, MA, 02114, USA.
Miroslav P
MP
Peev
Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Ashraf
A
Thabet
Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge Street, Boston, MA, 02114, USA.
Maria
M
Michailidou
Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge Street, Boston, MA, 02114, USA.
Yuchiao
Y
Chang
Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Peter R
PR
Mueller
Division of Abdominal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Peter F
PF
Hahn
Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge Street, Boston, MA, 02114, USA.
George C
GC
Velmahos
D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000706:statistics & numerical data; D001064:Appendicitis / Q000150:complications* / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D016154:Digestive System Fistula / Q000209:etiology / Q000628:therapy; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional; D055815:Young Adult
Abscess; Appendicitis; Interventional; Radiology