Jeffrey R B, Tolentino C S, Federle M P, Laing F C
AJR Am J Roentgenol. 1987 Jul;149(1):59-62. doi: 10.2214/ajr.149.1.59.
Twenty patients with periappendiceal abscesses diagnosed by CT underwent percutaneous catheter drainage. Eighteen (90%) of the 20 patients were successfully treated by percutaneous drainage and antibiotic therapy alone. In two of these patients, however, small recurrent abscesses were diagnosed by CT 4 and 6 weeks after drainage, but these abscesses resolved with additional antibiotic therapy. Surgery was performed in two patients in whom percutaneous drainage failed. One was a diabetic patient who had a gas-forming abscess that extended into the posterior pararenal space. Surgery was necessary in a second patient because of a technical failure of catheter insertion, which resulted in perforation of the abscess cavity and peritonitis. Abscess sinograms in eight (44%) of 18 patients showed fistulas between the abscess cavity and the base of the cecum or appendix. However, the fistulas did not pose a problem in clinical management, and all closed within 14 days. Percutaneous drainage is an effective alternative to surgery in selected patients with periappendiceal abscesses.
20例经CT诊断为阑尾周围脓肿的患者接受了经皮导管引流术。20例患者中有18例（90%）仅通过经皮引流和抗生素治疗即获得成功治疗。然而，在其中2例患者中，引流后4周和6周经CT诊断出小的复发性脓肿，但这些脓肿通过额外的抗生素治疗得以消退。2例经皮引流失败的患者接受了手术治疗。1例为糖尿病患者，其脓肿形成气体并延伸至肾后间隙。另1例患者因导管插入技术失败导致脓肿腔穿孔和腹膜炎而需要手术。18例患者中有8例（44%）的脓肿造影显示脓肿腔与盲肠或阑尾根部之间存在瘘管。然而，这些瘘管在临床管理中并未造成问题，且均在14天内闭合。对于部分阑尾周围脓肿患者，经皮引流是一种有效的手术替代方法。
