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Quality improvement guidelines for pediatric abscess and fluid drainage

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Abbreviations

INR:

International Normalized Ratio

References

  1. Fink A, Kosefcoff J, Chassin M et al (1984) Consensus methods: characteristics and guidelines for use. Am J Public Health 74:979–983

    Article  PubMed  CAS  Google Scholar 

  2. Bakal CW, Sacks D, Burke DR et al (2003) Quality improvement guidelines for adult percutaneous abscess and fluid drainage. J Vasc Interv Radiol 14(suppl):S223–S225

    PubMed  Google Scholar 

  3. Wallace MJ, Chin KW, Fletcher TB et al (2010) Quality improvement guidelines for percutaneous drainage/aspiration of abscess and fluid collections. J Vasc Interv Radiol 21:431–435

    Article  PubMed  Google Scholar 

  4. Hogan MJ (2003) Appendiceal abscess drainage. Tech Vasc Interv Radiol 6:205–214

    Article  PubMed  Google Scholar 

  5. Hogan MJ, Hoffer FA (2010) Biopsy and drainage techniques in children. Tech Vasc Interv Radiol 13:206–213

    Article  PubMed  Google Scholar 

  6. McCann JW, Maroo S, Wales P et al (2008) Image-guided drainage of multiple intraabdominal abscesses in children with perforated appendicitis: an alternative to laparotomy. Pediatr Radiol 38:661–668

    Article  PubMed  Google Scholar 

  7. Gervais DA, Brown SD, Connolly SA et al (2004) Percutaneous imaging guided abdominal and pelvic abscess drainage in children. Radiographics 24:737–754

    Article  PubMed  Google Scholar 

  8. Pereira JK, Chait PG, Miller SF (1996) Deep pelvic abscesses in children: transrectal drainage under radiologic guidance. Radiology 198:393–396

    PubMed  CAS  Google Scholar 

  9. Gervais DA, Hahn PF, O’Neill MJ et al (2000) CT-guided transgluteal drainage of deep pelvic abscesses in children: selective uses as an alternative to transrectal drainage. AJR 175:1393–1396

    PubMed  CAS  Google Scholar 

  10. Roach JP, Partrick DA, Bruny JL et al (2007) Complicated appendicitis in children: a clear role for drainage and delayed appendectomy. Am J Surg 194:769–772

    Article  PubMed  Google Scholar 

  11. Cahill AM, Baskin KM, Kaye RD et al (2005) Transgluteal approach for draining pelvic fluid collections in pediatric patients. Radiology 234:893–898

    Article  PubMed  Google Scholar 

  12. Curran TJ, Muenchow SK (1993) The treatment of complicated appendicitis in children using peritoneal drainage: results from a public hospital. J Pediatr Surg 28:204–208

    Article  PubMed  CAS  Google Scholar 

  13. Chung T, Hoffer FA, Lund DP (1996) Transrectal drainage of deep pelvic abscesses in children using a combined transrectal sonographic and fluoroscopic guidance. Pediatr Radiol 26:874–878

    Article  PubMed  CAS  Google Scholar 

  14. Koral K, Derinkuyu B, Gargan L et al (2010) Transrectal ultrasound and fluoroscopy-guided drainage of deep pelvic collections in children. J Pediatr Surg 45:513–518

    Article  PubMed  Google Scholar 

  15. Coley BD, Shiels WE II, Elton S et al (2004) Sonographically guided aspiration of cerebrospinal fluid pseudocysts in children and adolescents. AJR 83:1507–1510

    Google Scholar 

  16. Sidhu MK, Hogan MJ, Shaw DW et al (2009) Interventional radiology for paediatric trauma. Pediatr Radiol 39:506–515

    Article  PubMed  Google Scholar 

  17. Hultman CS, Herbst CA, McCall JM et al (1996) The efficacy of percutaneous cholecystostomy in critically ill patients. Am Surg 62:263–269

    PubMed  CAS  Google Scholar 

  18. Feola GP, Shaw CA, Coburn L (2003) Management of complicated parapneumonic effusions in children. Tech Vasc Interv Radiol 6:197–204

    Article  PubMed  Google Scholar 

  19. Hogan MJ, Coley BC (2008) Interventional radiology treatment of empyema and lung abscesses. Paediatr Respir Rev 9:77–84

    Article  PubMed  Google Scholar 

  20. Hawkins JA, Scaife ES, Hillman ND et al (2004) Current treatment of pediatric empyema. Semin Thorac Cardiovasc Surg 16:196–200

    Article  PubMed  Google Scholar 

  21. Cremonesini DA, Thomson AH (2007) How should we manage empyema: antibiotics alone, fibrinolytics, or primary video-assisted thoracoscopic surgery (VATS)? Semin Respir Crit Care Med 28:322–332

    Article  PubMed  Google Scholar 

  22. Jaffé A, Balfour-Lynn IM (2005) Management of empyema in children. Pediatr Pulmonol 40:148–156

    Article  PubMed  Google Scholar 

  23. Stefanutti G, Ghirardo V, Barbato A et al (2010) Evaluation of a pediatric protocol of intrapleural urokinase for pleural empyema: a prospective study. Surgery 148:589–594

    Article  PubMed  Google Scholar 

  24. Bianchini MA, Ceccarelli PL, Repetto P et al (2010) Once-daily intrapleural urokinase treatment of complicated parapneumonic effusion in pediatric patients. Turk J Pediatr 52:274–277

    PubMed  Google Scholar 

  25. Gates RL, Hogan M, Weinstein S et al (2004) Drainage, fibrinolytics, or surgery: a comparison of treatment options in pediatric empyema. J Pediatr Surg 39:1638–1642

    Article  PubMed  Google Scholar 

  26. Mahant S, Cohen E, Weinstein M et al (2010) Video-assisted thorascopic surgery vs chest drain with fibrinolytics for the treatment of pleural empyema in children: a systematic review of randomized controlled trials. Arch Pediatr Adolesc Med 164:201–203

    Article  PubMed  Google Scholar 

  27. St Peter SD, Tsao K, Harrison C et al (2009) Thoracoscopic decortication vs tube thoracostomy with fibrinolysis for empyema in children: a prospective, randomized trial. J Pediatr Surg 44:106–111

    Article  PubMed  Google Scholar 

  28. Sonnappa S, Cohen G, Owens CM et al (2006) Comparison of urokinase and video-assisted thoracoscopic surgery for treatment of childhood empyema. Am J Respir Crit Care Med 174:221–227

    Article  PubMed  Google Scholar 

  29. Patradoon-Ho P, Fitzgerald DA (2007) Lung abscess in children. Paediatr Respir Rev 8:77–84

    Article  PubMed  Google Scholar 

  30. Lorenzo RL, Bradford BF, Black J et al (1985) Lung abscesses in children: diagnostic and therapeutic needle aspiration. Radiology 157:79–80

    PubMed  CAS  Google Scholar 

  31. Ball BS, Bisset GS, Towbin RB (1989) Percutaneous drainage of chest abscesses in children. Radiology 171:431–434

    PubMed  Google Scholar 

  32. Hoffer FA, Bloom DA, Colin AA et al (1999) Lung abscess versus necrotizing pneumonia: implications for interventional therapy. Pediatr Radiol 29:87–91

    Article  PubMed  CAS  Google Scholar 

  33. Aliabadi P, Baker ND, Jaramillo D (1998) Hip arthrography, aspiration, block, and bursography. Radiol Clin North Am 36:673–690

    Article  PubMed  CAS  Google Scholar 

  34. Shiels WE II, Kang DR, Murakami JW et al (2009) Percutaneous treatment of lymphatic malformations. Otolaryngol Head Neck Surg 141:219–224

    Article  PubMed  Google Scholar 

  35. Zawin JK, Hoffer FA, Rand FF et al (1993) Joint effusion in children with an irritable hip: US diagnosis and aspiration. Radiology 187:459–463

    PubMed  CAS  Google Scholar 

  36. Zamzam MM (2006) The role of ultrasound in differentiating septic arthritis from transient synovitis of the hip in children. J Pediatr Orthop B 15:418–422

    Article  PubMed  Google Scholar 

  37. American College of Radiology/Society of Interventional Radiology. ACRSIR practice guideline for specifications and performance of image guided percutaneous drainage/aspiration of abscesses and fluid collections (PDAFC) in adults. Available at http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/PDAFC.pdf. Accessed 11 June 2012

  38. Rozovsky K, Hiller N, Koplewitz BZ (2010) Does CT have an additional diagnostic value over ultrasound in the evaluation of acute inflammatory neck masses in children? Eur Radiol 20:484–490

    Article  PubMed  Google Scholar 

  39. Sidhu M, Strauss KJ, Connolly MB et al (2010) Radiation safety in pediatric interventional radiology. Tech Vasc Interv Radiol 13:158–166

    Article  PubMed  Google Scholar 

  40. (2006) Health risks from exposure to low levels of ionizing radiation: BEIR VII Phase 2. Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation, Washington DC, pp 1–32

  41. Stecker MS, Balter S, Towbin RB et al (2009) Guidelines for patient radiation dose management. J Vasc Interv Radiol 20(suppl):S263–S273

    Article  PubMed  Google Scholar 

  42. Hall EJ (2009) Radiation biology for pediatric radiologists. Pediatr Radiol 39(suppl 1):S57–S64

    Article  PubMed  Google Scholar 

  43. Cravero JP, Blike GT, Beach M et al (2006) Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium. Pediatrics 118:1087–1096

    Article  PubMed  Google Scholar 

  44. Mason KP (2009) Pediatric procedures in interventional radiology. Int Anesthesiol Clin 47:35–43

    Article  PubMed  Google Scholar 

  45. American College of Radiology/Society of Interventional Radiology. ACRSIR practice guideline for sedation/analgesia. Available at http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Adult_Sedation.pdf, Accessed 11 June 2012

  46. Lasson A, Lundagards J, Loren I et al (2002) Appendiceal abscesses: primary percutaneous drainage and selective interval appendicectomy. Eur J Surg 168:264–269

    Article  PubMed  Google Scholar 

  47. Price MR, Haase GM, Sartorelli KH et al (1996) Recurrent appendicitis after initial conservative management of appendiceal abscess. J Pediatr Surg 31:291–294

    Article  PubMed  CAS  Google Scholar 

  48. Sivit CJ, Applegate KE (2003) Imaging of acute appendicitis in children. Semin Ultrasound CT MR 24:74–82

    Article  PubMed  Google Scholar 

  49. Newman K, Ponsky T, Kittle K et al (2003) Appendicitis 2000: variability in practice, outcomes, and resource utilization at thirty pediatric hospitals. J Pediatr Surg 38:372–379

    Article  PubMed  Google Scholar 

  50. American College of Radiology/Society of Interventional Radiology. ACRSIR guideline on informed consent for image-guided procedures, Available at http://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Informed_Consent_Image_Guide.pdf, Accessed 11 June 2012

  51. Malloy PC, Grassi CJ, Kundu S et al (2009) Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided intervention. J Vasc Interv Radiol 20(suppl):S240–S249

    Article  PubMed  Google Scholar 

  52. Venkatesan AM, Kundu S, Sacks D et al (2010) Practice guideline for adult antibiotic prophylaxis during vascular and interventional radiology procedures. J Vasc Interv Radiol 21:1611–1630

    Article  PubMed  Google Scholar 

  53. Pearce MS, Salotti JA, Little MR et al (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumors: a retrospective cohort study. Lancet 380:499–505

    Article  PubMed  Google Scholar 

  54. Govia K, Connolly BL, Thomas KE et al (2012) Estimates of effective dose to pediatric patients undergoing enteric and venous access procedures. J Vasc Interv Radiol 23:443–450

    Article  PubMed  Google Scholar 

  55. Miller DL, Vano E, Bartal G et al (2010) Occupational radiation protection in interventional radiology; a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. J Vasc Interv Radiol 21:607–615

    Article  PubMed  Google Scholar 

  56. Burrows PF, Robertson RL, Barnes PD (1996) Angiography and the evaluation of cerebrovascular disease in childhood. Neuroimaging Clin N Am 6:561–588

    PubMed  CAS  Google Scholar 

  57. Lock J, Keane J, Perry S (2000) Diagnostic and interventional catheterization in congenital heart disease, 2nd edn. Kluwer, Boston

    Google Scholar 

  58. Walser E, Raza S, Hernandex A et al (2003) Sonographically guided transgluteal drainage of pelvic abscesses. AJR 181:498–500

    PubMed  Google Scholar 

  59. Rao S, Hogan MJ (2009) Trocar transrectal abscess drainage in children: a modified technique. Pediatr Radiol 39:982–984

    Article  PubMed  Google Scholar 

  60. Alexander AA, Eschelman DJ, Nazarian LN et al (1994) Transrectal sonographically guided drainage of deep pelvic abscesses. AJR 162:1227–1230

    PubMed  CAS  Google Scholar 

  61. Fan WC, Chan CC, Chan JCS (2008) Image guided drainage using the trocar technique. J HK Coll Radiol 11:69–71

    Google Scholar 

  62. Cheng D, Nagata KT, Yoon HC (2008) Randomized prospective comparison of alteplase versus saline solution for the percutaneous treatment of loculated abdominopelvic abscesses. J Vasc Interv Radiol 19:906–911

    Article  PubMed  Google Scholar 

  63. Diamond IR, Wales PW, Connolly B et al (2003) Tissue plasminogen activator for the treatment of intraabdominal abscesses in a neonate. J Pediatr Surg 38:1234–1236

    Article  PubMed  Google Scholar 

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Acknowledgments

Mark J. Hogan, MD, authored the first draft of this document and served as topic leader during the subsequent revisions of the draft. Wael A. Saad, MD, is chair of the SIR Standards of Practice Committee. Richard B. Towbin, MD, and Bairbre L. Connolly, MD, are co-chairs of Pediatric Interventional Radiology Subcommittee. John F. Cardella, MD, is Councilor of the SIR Standards Division. Other members of the Standards of Practice Committee and SIR who participated in the development of this clinical practice guideline are (listed alphabetically): Kevin M. Baskin, MD, and Josee Dubois, MD.

Author disclaimer

W.A.S. has research funded by Siemens (Forchheim, Germany) and is a paid consultant for Boston Scientific (Natick, MA). None of the other authors have identified a conflict of interest.

SIR disclaimer

The clinical practice guidelines of the Society of Interventional Radiology attempt to define practice principles that generally should assist in producing high quality medical care. These guidelines are voluntary and are not rules. A physician may deviate from these guidelines, as necessitated by the individual patient and available resources. These practice guidelines should not be deemed inclusive of all proper methods of care or exclusive of other methods of care that are reasonably directed towards the same result. Other sources of information may be used in conjunction with these principles to produce a process leading to high quality medical care. The ultimate judgment regarding the conduct of any specific procedure or course of management must be made by the physician, who should consider all circumstances relevant to the individual clinical situation. Adherence to the SIR Quality Improvement Program will not assure a successful outcome in every situation. It is prudent to document the rationale for any deviation from the suggested practice guidelines in the department policies and procedure manual or in the patient’s medical record.

Author information

Authors and Affiliations

  1. Department of Radiology, Nationwide Children’s Hospital, Columbus, OH, USA

    Mark J. Hogan

  2. c/o D. Katsarelis, 3975 Fair Ridge Drive, Suite 400N, Fairfax, VA, 22033, USA

    Mark J. Hogan

  3. Department of Radiology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA

    Francis E. Marshalleck

  4. Department of Radiology, Seattle Children’s Hospital, University of Washington, Seattle, WA, USA

    Manrita K. Sidhu

  5. Center for Image Guided Therapy, Hospital for Sick Children, University of Toronto, Toronto, Canada

    Bairbre L. Connolly & Michael J. Temple

  6. Department of Radiology, British Columbia Children’s Hospital, Vancouver General Hospital, Vancouver, Canada

    Manraj K. S. Heran

  7. Department of Radiology, Phoenix Children’s Hospital, Phoenix, AZ, USA

    Richard B. Towbin

  8. Department of Radiology, University of Virginia Health System, Charlottesville, VA, USA

    Wael A. Saad

  9. Department of Interventional Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Ann Marie Cahill

  10. Department of Radiology, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    John Crowley

  11. Department of Radiology, Geisinger Health System, Danville, PA, USA

    John F. Cardella

  12. Department of Radiology, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, Milwaukee, WI, USA

    Eric J. Hohenwalter

  13. Department of Radiology, Great Ormond Street Hospital, London, UK

    Derek J. Roebuck

  14. Division of Vascular Imaging and Intervention, Massachusetts General Hospital, Boston, MA, USA

    T. Gregory Walker

Authors
  1. Mark J. Hogan
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  2. Francis E. Marshalleck
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  3. Manrita K. Sidhu
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  4. Bairbre L. Connolly
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  5. Richard B. Towbin
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  6. Wael A. Saad
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  7. Ann Marie Cahill
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  8. John Crowley
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  9. Manraj K. S. Heran
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  10. Eric J. Hohenwalter
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  11. Derek J. Roebuck
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  12. Michael J. Temple
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  13. T. Gregory Walker
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  14. John F. Cardella
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Consortia

Members from the Society of Interventional Radiology Standards of Practice Committee and Society for Pediatric Radiology Interventional Radiology Committee

Corresponding author

Correspondence to Mark J. Hogan.

Additional information

This article was published in the November issue of the Journal of Vascular and Interventional Radiology. The articles are identical except for minor stylistic and spelling differences in keeping with each journal’s style. Either citation can be used when citing this article. Permission to reproduce this article can be granted by SIR. To request permission to print this article in a journal Web site, or other publication, please contact the SIR at dkatsarelis@sirweb.org. © SIR 2012. J Vasc Interv Radiol 2012 23(11):1397–1402. http://dx.doi.org/10.1016/j.jvir.2012.06.016

Appendix: Consensus methodology

Appendix: Consensus methodology

Reported complication-specific rates in some cases reflect the aggregate of major and minor complications. Thresholds are derived from critical evaluation of the literature, evaluation of empirical data from Standards of Practice Committee members’ practices, and, when available, the SIR Hi-IQ System national database.

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Hogan, M.J., Marshalleck, F.E., Sidhu, M.K. et al. Quality improvement guidelines for pediatric abscess and fluid drainage. Pediatr Radiol 42, 1527–1535 (2012). https://doi.org/10.1007/s00247-012-2499-7

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  • DOI: https://doi.org/10.1007/s00247-012-2499-7

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