Postoperative timing of computed tomography scans for abscess in pediatric appendicitis

• Published in: The Journal of surgical research 2016, Vol.200 (1), p.1-7
• Main Authors: Nielsen, Jason W., MD, Kurtovic, Kelli J., BS, Kenney, Brian D., MD, MPH, A. Diefenbach, Karen, MD
• Format: Article
• Language: English
• Subjects: Abdominal Abscess - diagnostic imaging; Abdominal Abscess - etiology; Abdominal Abscess - therapy; Abscess; Adolescent; Appendectomy; Appendicitis; Appendicitis - surgery; Child; Child, Preschool; Drainage - utilization; Female; Humans; Infant; Length of Stay; Male; Outcome Assessment (Health Care); Postoperative Care - methods; Postoperative Complications - diagnostic imaging; Postoperative Complications - therapy; Retrospective Studies; Surgery; Time Factors; Timing; Tomography, X-Ray Computed
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2015.03.089

Abstract 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