Retrospective analysis of single-center experience in ultrasound-guided puncture drainage for pediatric appendiceal abscess.

OBJECTIVE

To evaluate the clinical efficacy of ultrasound-guided puncture drainage for pediatric appendiceal abscess and summarize operational experience.

METHODS

This study conducted a retrospective analysis of clinical data from pediatric patients who underwent ultrasound-guided percutaneous drainage for appendiceal abscess at Beijing Children's Hospital between January 2022 and June 2025. The safety and efficacy of ultrasound-guided abscess drainage were analyzed, along with key technical points and experiences for different types of appendiceal abscesses. Categorical variables were compared using the χ 2 or Fisher's exact test, and continuous variables were analyzed using the t-test or Mann-Whitney U test. A P-value < 0.05 was considered statistically significant.

RESULTS

A total of 90 children underwent ultrasound-guided puncture of the appendiceal abscess and were included in this study, and the control group consisted of 41 children with appendiceal abscess who received conservative treatment during the same period. Children who underwent ultrasound-guided abscess drainage under local anesthesia showed a faster decrease in white blood cell count (7.0 ± 2.0 vs. 11.0 ± 3.0 × 109/L; t = 4.0, P < 0.05) and C-reactive protein levels (7.3 ± 2.1 vs. 11.3 ± 3.1 mg/L; t = -7.6, P < 0.05) after one week of treatment, shorter duration of abdominal pain (4.3 ± 1.5 vs. 5.8 ± 1.3 days; t = -5.7, P < 0.05), and quicker resolution of the abscess compared (11.3 ± 1.2 vs. 15.7 ± 1.1 days; t = -21.1, P < 0.05) to those who received intravenous antibiotics alone. Ultrasound-guided abscess drainage resulted in minimal trauma and lower rates of early and late postoperative complications. A retrospective review of ultrasound data from 90 children who underwent ultrasound-guided abscess drainage demonstrated that our hospital had extensive operational experience in performing drainage for various types of complicated appendiceal abscesses.

CONCLUSION

Ultrasound-guided percutaneous drainage is a safe and effective minimally invasive treatment for pediatric appendiceal abscess in children who can cooperate with local anesthesia. Physicians must master the indications for drainage and specific puncture techniques for different types of appendiceal abscesses.