Abscess due to perforated appendicitis: factors associated with successful percutaneous drainage

2016 ◽  
Vol 212 (4) ◽  
pp. 794-798 ◽  
Author(s):  
Peter J. Fagenholz ◽  
Miroslav P. Peev ◽  
Ashraf Thabet ◽  
Maria Michailidou ◽  
Yuchiao Chang ◽  
...  
Keyword(s):  
Percutaneous Drainage ◽  
Perforated Appendicitis ◽  
Factors Associated

Differences in the Management of Perforated Appendicitis in Children by Race and Insurance Status

2017 ◽  
Vol 83 (9) ◽  
pp. 996-1000 ◽  
Author(s):  
Randi L. Lassiter ◽  
Robyn M. Hatley
Keyword(s):  
Household Income ◽  
Percutaneous Drainage ◽  
Management Strategies ◽  
Disease Process ◽  
Perforated Appendicitis ◽  
Black Children ◽  
Primary Diagnosis ◽  
Insurance Status ◽  
Similar Disease ◽  
Using Data

This study was conducted to assess whether race and socioeconomic status influence the management method used to treat pediatric perforated appendicitis. Nonelective pediatric admissions with a primary diagnosis of appendicitis were analyzed using data from the 2001–2010 Nationwide Inpatient Sample. Bivariate and multivariate analyses were used to determine the association between race, insurance status, median household income, rural/metropolitan location, and the risk adjusted odds of undergoing surgery, laparoscopic appendectomy, percutaneous drainage, or neither surgery nor percutaneous drainage. A total of 46,211 admissions of perforated appendicitis were identified. Surgery was performed in 90.5 per cent of them. Black children were less likely to have surgery [adjusted odds ratio (AOR) = 0.53] and more likely to be managed non-surgically with percutaneous drainage (AOR = 1.79). Self-pay patients were less likely to have laparoscopic surgery (AOR = 0.80). Children from rural counties were more likely to undergo surgery than those from larger metropolitan areas (AOR = 1.30). Higher estimated household income did not predict the method of treatment. Although previous studies have attributed racial disparities in outcomes for appendicitis to different rates of perforation and access to care, these findings demonstrate significantly dissimilar management strategies for patients presenting with a similar disease process.

Factors Associated with Failed Endoscopic Drainage Requiring Percutaneous Drainage in Hilar Cholangiocarcinoma

2016 ◽  
Vol 111 ◽  
pp. S48
Author(s):  
Tossapol Kerdsirichairat ◽  
Pranith Perera ◽  
Jennifer Jorgensen ◽  
Michelle Anderson ◽  
Grace Elta ◽  
...  
Keyword(s):  
Percutaneous Drainage ◽  
Hilar Cholangiocarcinoma ◽  
Endoscopic Drainage ◽  
Factors Associated

scholarly journals Determinants of postoperative abscess occurrence and percutaneous drainage in children with perforated appendicitis

2014 ◽  
Vol 30 (12) ◽  
pp. 1265-1271 ◽  
Author(s):  
Sherif Emil ◽  
Sherif Elkady ◽  
Layla Shbat ◽  
Fouad Youssef ◽  
Robert Baird ◽  
...  
Keyword(s):  
Percutaneous Drainage ◽  
Perforated Appendicitis

Percutaneous drainage of intra-abdominal abscess in children with perforated appendicitis

2012 ◽  
Vol 42 (7) ◽  
pp. 805-812 ◽  
Author(s):  
Michael F. McNeeley ◽  
Nghia Jack Vo ◽  
Somnath J. Prabhu ◽  
Jason Vergnani ◽  
Dennis W. Shaw
Keyword(s):  
Percutaneous Drainage ◽  
Perforated Appendicitis ◽  
Abdominal Abscess

Return to the System within 30 Days of Discharge after Pediatric Appendectomy

2016 ◽  
Vol 82 (7) ◽  
pp. 626-631 ◽  
Author(s):  
Heather L. Short ◽  
Samir Sarda ◽  
Kurt F. Heiss ◽  
Joshua J. Chern ◽  
Mehul V. Raval
Keyword(s):  
Emergency Department ◽  
Regression Models ◽  
Nonoperative Management ◽  
Perforated Appendicitis ◽  
Hospital Level ◽  
Single Institution ◽  
Index Procedure ◽  
Factors Associated ◽  
Clinical Events ◽  
Reoperation Rates

Postprocedural revisits, readmissions, and reoperations are commonly tracked quality metrics and have reimbursement and hospital-level comparison implications. Our purpose was to document these rates after pediatric appendectomy and to identify patient factors related to these metrics. This study included 3756 appendectomies performed at a single institution from 2009 to 2013. Data were prospectively collected and clinical events within 30 days of discharge were analyzed. Regression models identified factors associated with each metric. There were 328 returns to the emergency department (8.7%), 128 readmissions (3.4%), and 41 reoperations (1.0%). The main source of read-mission was the emergency department (n = 118, 92%). Nearly two-thirds of readmissions were nonoperative (n = 87, 68%) and 12.5 per cent of readmissions were not related to the index appendectomy. Factors associated with readmission include procedure length >70 minutes [odds ratio (OR) 1.89, P = 0.043] and failed nonoperative management of perforated appendicitis (OR 2.97, P = 0.041). The most common indication for reoperation was intra-abdominal abscess (n = 20,49%), 55 per cent of which were managed with image-guided drainage. In conclusion, although 30-day revisit, read-mission, and reoperation rates after appendectomy are low, there are opportunities for improvement. Furthermore, many 30-day readmissions are not related to the index procedure and must be clearly identified to avoid inaccuracies with reimbursement and quality rankings.

scholarly journals Resource utilization and outcomes from percutaneous drainage and interval appendectomy for perforated appendicitis with abscess

2008 ◽  
Vol 43 (6) ◽  
pp. 977-980 ◽  
Author(s):  
Scott J. Keckler ◽  
Kuojen Tsao ◽  
Susan W. Sharp ◽  
Daniel J. Ostlie ◽  
George W. Holcomb ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Percutaneous Drainage ◽  
Perforated Appendicitis ◽  
Interval Appendectomy

scholarly journals Are Pyogenic Liver Abscesses Still a Surgical Concern? A Western Experience

HPB Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Barbara Alkofer ◽  
Corentin Dufay ◽  
Jean Jacques Parienti ◽  
Vincent Lepennec ◽  
Sylvie Dargere ◽  
...  
Keyword(s):  
Septic Shock ◽  
Medical Treatment ◽  
Liver Abscess ◽  
Percutaneous Drainage ◽  
Pyogenic Liver Abscess ◽  
Percutaneous Treatment ◽  
University Hospital ◽  
Factors Associated ◽  
Standard Management ◽  
Western Experience

Backgrounds. Pyogenic liver abscess is a rare disease whose management has shifted toward greater use of percutaneous drainage. Surgery still plays a role in treatment, but its indications are not clear. Method. We conducted a retrospective study of pyogenic abscess cases admitted to our university hospital between 1999 and 2010 and assessed the factors potentially associated with surgical treatment versus medical treatment alone. Results. In total, 103 liver abscess patients were treated at our center. The mortality was 9%. The main symptoms were fever and abdominal pain. All of the patients had CRP > 6 g/dL. Sixty-nine patients had a unique abscess. Seventeen patients were treated with antibiotics alone and 57 with percutaneous drainage and antibiotics. Twenty-seven patients who were treated with percutaneous techniques required surgery, and 29 patients initially received it. Eventually, 43 patients underwent abscess surgery. The factors associated with failed medical treatment were gas-forming abscess and septic shock at the initial presentation . Conclusion. Medical and percutaneous treatment constitute the standard management of liver abscess cases. Surgery remains necessary after failure of the initial treatment but should also be considered as an early intervention for cases presenting with gas-forming abscesses and septic shock and when treatment of the underlying cause is immediately required.

Childhood Appendicitis: Factors Associated with Perforation

PEDIATRICS ◽  
1985 ◽  
Vol 76 (2) ◽  
pp. 301-306
Author(s):  
Jean D. Brender ◽  
Edgar K. Marcuse ◽  
Thomas D. Koepsell ◽  
Edwin I. Hatch
Keyword(s):  
Abdominal Pain ◽  
Family History ◽  
Perforated Appendicitis ◽  
Older Children ◽  
Factors Associated ◽  
Mean Delay ◽  
Care Family ◽  
History Of ◽  
Regression Techniques ◽  
Delay In Treatment

A retrospective study was performed to identify factors associated with perforation in 150 children with acute appendicitis. The children's parents were interviewed about the nature and timing of care, family history of appendicitis, and history of abdominal pain episodes, and the children's medical records were reviewed. Delay in treatment—the interval between first recognized symptoms of abdominal pain and surgery—was most predictive of perforation. A treatment delay of more than 36 hours was associated with a 65% or greater incidence of perforation. Mean delay for the group with perforation of the appendix was 66.7 hours compared with 35.8 hours for the group having appendicitis without perforation (P < .01). Mean professional delay was significantly longer in the group with perforated appendicitis than in the group having appendicitis without perforation (P < .01), but mean parental delay was not. Children aged 1 to 4 years and those aged 5 to 8 years had a 74% and 66% incidence of perforation, respectively, compared with a 30% to 42% incidence in older children (P < .01). Age had a significant effect upon perforation even when adjusted for delay in treatment. Other factors associated with perforation were family history of appendicitis, social class, advice given by the first health professional contacted, and the presence of fecaliths. When all factors were considered simultaneously by using logistic regression techniques, delay in treatment, age, and absence of a family history of appendicitis were all significant predictors of perforation.

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