Baker Kim A, Stuart James, Sykes Kevin J, Sinclair Kelly A, Wei Julie L
Section of Otolaryngology-Head and Neck Surgery, Children's Mercy Hospital and Clinics, Kansas City, MO 64108, USA.
Pediatr Emerg Care. 2012 Oct;28(10):962-5. doi: 10.1097/PEC.0b013e31826c6c36.
The objective of this study was to review our pediatric emergency department's (ED's) utilization of computed tomography (CT) in the diagnosis of peritonsillar abscess (PTA) and treatment outcomes.
This study used case series with chart review.
From January 2007 to January 2009, 148 patients were seen in our ED for possible PTA. Mean age at presentation was 11.8 years (range, 10 months to 18 years); 81 (54.7%) of 148 were females. Computed tomography was ordered in 96 (64.9%) of 148 patients, of which 73 (49.3%) 148 were confirmed to have PTA. Mean age of patients who underwent CT was younger when compared with those who did not have CT performed (mean, 11 vs 13 years; P = 0.02). Unilateral PTA was found in 65 (43.9%) of 148, bilateral in 8 (5.4%) of 148, and intratonsillar in 25 patients (16.9%). Concomitant CT findings of parapharyngeal space involvement were found in 19 (12.8%), and retropharyngeal space involvement in 11 (7.4%). Admission was necessary for 104 (71.2%) of 148 patients, whereas 42 were discharged from the ED. Transoral needle aspiration and/or incision and drainage were performed in the ED in 41 patients, with purulence identified in 33 (80.5%) of 41. Rapid strep testing was positive in 40 (32%) of 124 patients tested. Operative treatment was necessary in 44 patients (29.7%), 34 underwent incision and drainage, and 10 underwent quinsy tonsillectomy.
Computed tomography is commonly utilized in the ED for the evaluation of PTA and is ordered more often in younger children.
本研究的目的是回顾我院儿科急诊科利用计算机断层扫描（CT）诊断扁桃体周围脓肿（PTA）的情况及治疗结果。
本研究采用病例系列结合病历回顾的方法。
2007年1月至2009年1月，我院急诊科共诊治148例疑似PTA患者。就诊时的平均年龄为11.8岁（范围为10个月至18岁）；148例患者中81例（54.7%）为女性。148例患者中有96例（64.9%）接受了CT检查，其中73例（49.3%）确诊为PTA。接受CT检查的患者平均年龄比未接受CT检查的患者小（平均年龄分别为11岁和13岁；P = 0.02）。148例患者中65例（43.9%）为单侧PTA，8例（5.4%）为双侧PTA，25例（16.9%）为扁桃体内PTA。CT检查同时发现咽旁间隙受累19例（12.8%），咽后间隙受累11例（7.4%）。148例患者中有104例（71.2%）需要住院，42例从急诊科出院。41例患者在急诊科接受了经口针吸和/或切开引流，41例中有33例（80.5%）发现有脓性分泌物。124例接受检测的患者中40例（32%）快速链球菌检测呈阳性。44例患者（29.7%）需要手术治疗，34例行切开引流，10例行扁桃体周围脓肿切除术。
CT在急诊科常用于PTA的评估，且在年幼儿童中更常被使用。
