Postoperative timing of computed tomography scans for abscess in pediatric appendicitis
| Autor: | Brian D. Kenney, Kelli J. Kurtovic, Karen A. Diefenbach, Jason W. Nielsen |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Abdominal Abscess Time Factors Adolescent Computed tomography 03 medical and health sciences 0302 clinical medicine Postoperative Complications 030225 pediatrics Outcome Assessment Health Care medicine Appendectomy Humans Pediatric appendicitis Abscess Child Retrospective Studies Postoperative Care medicine.diagnostic_test business.industry Infant Retrospective cohort study Length of Stay medicine.disease Appendicitis Surgery Tomography x ray computed 030220 oncology & carcinogenesis Child Preschool Drainage Female Radiology business Tomography X-Ray Computed Ruptured appendicitis |
| Zdroj: | The Journal of surgical research. 200(1) |
| ISSN: | 1095-8673 |
| Popis: | Background One-quarter to one half of pediatric appendicitis patients present with ruptured appendicitis and about 3%–25% go on to form postoperative intra-abdominal abscesses. The optimal timing of postoperative imaging for suspected abscess formation has been a subject of debate. Methods All patients who underwent appendectomy for complex appendicitis and were not discharged before postoperative day (POD) #5 from April 2012–October 2014 were identified. Patients were stratified into groups for comparison as follows: group 1 had postoperative computed tomography (CT) scans before POD#7 ( n = 26) and group 2 did not ( n = 169). Group 2 was further divided into those who were afebrile (group 2a, n = 106) or febrile (group 2b, n = 63) at POD#5. Results A total of 195 patients met criteria. Early use of CT scans resulted in more drainage procedures (group 1, 73.1% versus group 2b, 28.6%, P versus 9.5%). The groups had equivalent lengths of stay (11.9 versus 9.8 d, P = 0.10) and readmission rates due to abscesses (19.2% group 1 versus 6.3%, group 2b, P = 0.12) with no septic events. In total, 130 of the 169 patients (76.9%) in group 2 had resolution of symptoms before discharge without intervention with readmission for abscess in only 5.9%. Conclusions Waiting until POD#7 before scanning led to fewer drainage procedures and recurrent CT scans without increasing length of stay or readmission rates. Most complex appendicitis patients still admitted at POD#5 had resolution of symptoms without need for intervention. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect