Colonic Perforation-Complication of Percutaneous Drainage of Appendiceal...

As a male patient with 8 years old. Uh, 10 days with abdominal pain, uh, ambulary treatment with antibiotics and analhesive without clear diagnosis. Next slide, please. Next slide. Yep. Next slide. Thank you. Next slide. When she arrived at the emergency room, she had an abdominal mass and a tomography showed a big collection at right iliac fossa. Next slide. Uh, percutaneous drainage was practiced by interventional radiology, and a catheter was left in sum. The next day, the girl exhibit bleeding through the catheter. Next, thank you. The radiologist practice another tomography and abdominal Xs with contracts medium through the catheters. Next, The patient had the catheter in the cecum and then the the radiologist removed it. We decided to continue the active observation and antibiotic treatment with 10 days. A week later, the ultrasound showed that the abscess had missing, and after 8 weeks at the last control, she was nice and the ultrasound was normal. Given that the patient did not have appendicolli, we did not consider internal appendectomy. Uh, and a question, when do you use the percutaneous drainage in appendiceal abscess, all cases or only in a special situation? It's possible to use only antibiotics and the percutanerena in patient cases with bad evolution. What factors do you consider that affect the recurrence of appendices? Thank you. So, uh, I, I wanna answer your question, and then I'm gonna turn over about, uh, how would people approach, uh, an abscess and, um, would they, would they drain or not because we asked this, uh, a few months ago to the global cast audience and I'm trying to find the results here, but I believe the majority, um, almost 60%, um, would do a percutaneous drain. Um, instead of operating on someone who has a well-formed abscess, uh, just curious before we move on if the faculty here disagrees with that, would the majority of you and this patient have put in a percutaneous drain? Is there, is there anyone that wouldn't? OK. That answers that question. Uh, so now, so what about, um, the, would, would you have managed anything different with this patient? So, we have a, a drain that, uh, looks like it's, it's perforated into the colon. Has anyone seen a colonic injury from a percutaneous drain before? Yes, I know, we know you have. We've had, well, we've had, I've seen small bowel injuries. I'm not, I'm not sure we've recognized the colonic injury because how would you know? Right? Because this is what happens if you just, you don't have an obstructive pattern, so you can back the catheter out. Now, to your question, it sounds like they just took it right out. I've backed it out when there's a scenario like that and it works fine. Maybe you can just take it out. Yeah, yeah, we usually just take them out. All right. Um, that's a great case. I appreciate you presenting that. If anyone has any other comments.