Jeffrey R B, Federle M P, Tolentino C S
Department of Radiology, San Francisco General Hospital, CA 94110.
Radiology. 1988 Apr;167(1):13-6. doi: 10.1148/radiology.167.1.3347712.
The outcome was reviewed in 70 patients with computed tomographic (CT) and clinical evidence of periappendiceal inflammatory masses. On the basis of the initial CT scan, patients were divided into three broad categories: (a) patients with periappendiceal phlegmons or abscesses less than 3 cm (n = 32); (b) patients with well-defined and well-localized periappendiceal abscesses greater than 3 cm (n = 28); and (c) patients with extensive, poorly defined periappendiceal abscesses with either pelvic, retroperitoneal, or interloop involvement (n = 10). Thirty-two patients with either phlegmons or small abscesses were treated initially with antibiotic therapy alone; clinical resolution of the inflammatory process occurred in 28 patients (88%). Twenty-eight patients with well-defined and well-localized periappendiceal abscesses underwent percutaneous catheter drainage, which was successful in 26 patients (93%). Nine of ten patients underwent early surgical drainage for extensive, poorly defined abscesses. One patient underwent percutaneous drainage as a temporizing measure before surgery. There were three false-positive CT diagnoses of periappendiceal abscesses in this series.
对70例有计算机断层扫描（CT）及阑尾周围炎性包块临床证据的患者的治疗结果进行了回顾。根据最初的CT扫描结果，患者被分为三大类：（a）阑尾周围蜂窝织炎或脓肿小于3 cm的患者（n = 32）；（b）边界清晰且定位良好的大于3 cm的阑尾周围脓肿患者（n = 28）；（c）阑尾周围脓肿范围广泛、边界不清且累及盆腔、腹膜后或肠袢间的患者（n = 10）。32例有蜂窝织炎或小脓肿的患者最初仅接受抗生素治疗；28例患者（88%）炎症过程临床消退。28例边界清晰且定位良好的阑尾周围脓肿患者接受了经皮导管引流，26例患者（93%）成功。10例患者中有9例因脓肿范围广泛、边界不清而接受了早期手术引流。1例患者在手术前接受了经皮引流作为临时措施。本系列中有3例假阳性的阑尾周围脓肿CT诊断。
