REGULAR CONTENT
Final ID
629
Type
Educational Exhibit-Poster Only
Authors
D Hu1, D Ashton2
Institutions
1Baylor College of Medicine, Houston, TX, 2Texas Children's Hospital, Houston, TX
Purpose
Abscess secondary to a specific nidus requires removal of the nidus to fully clear the infection. This can require repeat surgical interventions in the case of a retained appendicolith. This study reports our experiences with percutaneous removal of infection nidus at our institution.
Materials & Methods
Electronic medical records and PACS were searched for drain placements that also included the attempted removal of an abscess nidus from January 2013 through December 2015 by our Interventional Radiology department. Procedure details and clinical follow up including operative management were added to a HIPPA compliant database.
Results
There were 5 patients who received an abscess drain and also attempted removal of infection nidus in IR. Four were appendicoliths and one was a pellet retained from an injury that occurred the year prior. Of the appendicoliths, one presented with acute perforated appendicitis, two as retained stones after surgery, and one stone that had migrated into the right chest with resultant empyema. Removal of the nidus or fragmentation and aspiration was successful in all cases except for the perforated appendicitis. The treated abscess resolved in all cases. The case of perforated appendicitis underwent uneventful interval appendectomy 2 months after presentation.
Conclusions
Percutaneous removal of an abscess nidus at the time of drain placement is feasible. Attempts to remove an abscess nidus during drain placement may obviate the need for additional surgical intervention.
Final ID
629
Type
Educational Exhibit-Poster Only
Authors
D Hu1, D Ashton2
Institutions
1Baylor College of Medicine, Houston, TX, 2Texas Children's Hospital, Houston, TX
Purpose
Abscess secondary to a specific nidus requires removal of the nidus to fully clear the infection. This can require repeat surgical interventions in the case of a retained appendicolith. This study reports our experiences with percutaneous removal of infection nidus at our institution.
Materials & Methods
Electronic medical records and PACS were searched for drain placements that also included the attempted removal of an abscess nidus from January 2013 through December 2015 by our Interventional Radiology department. Procedure details and clinical follow up including operative management were added to a HIPPA compliant database.
Results
There were 5 patients who received an abscess drain and also attempted removal of infection nidus in IR. Four were appendicoliths and one was a pellet retained from an injury that occurred the year prior. Of the appendicoliths, one presented with acute perforated appendicitis, two as retained stones after surgery, and one stone that had migrated into the right chest with resultant empyema. Removal of the nidus or fragmentation and aspiration was successful in all cases except for the perforated appendicitis. The treated abscess resolved in all cases. The case of perforated appendicitis underwent uneventful interval appendectomy 2 months after presentation.
Conclusions
Percutaneous removal of an abscess nidus at the time of drain placement is feasible. Attempts to remove an abscess nidus during drain placement may obviate the need for additional surgical intervention.