Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgment
- Section 1 Head and neck
- Section 2 Thoracic imaging
- Section 3 Cardiac imaging
- Section 4 Vascular and interventional
- Case 33 Lower extremity ischemia due to homocystinuria
- Case 34 Iatrogenic pathology masquerading as an artifact
- Case 35 Fibromuscular dysplasia
- Case 36 Traumatic vertebral arteriovenous fistulae
- Case 37 Colonic perforation during intussusception reduction
- Case 38 Juvenile nasopharyngeal angioma
- Case 39 Small bowel fistula complicating perforated appendicitis: successful treatment with tissue adhesive
- Case 40 Extrahepatic collateral arterial supply to hepatocellular carcinoma
- Case 41 Use of a curved needle to access an otherwise inaccessible abscess
- Case 42 Umbilical venous catheter malposition
- Case 43 Middle aortic syndrome
- Section 5 Gastrointestinal imaging
- Section 6 Urinary imaging
- Section 7 Endocrine - reproductive imaging
- Section 8 Fetal imaging
- Section 9 Musculoskeletal imaging
- Index
- References
Case 39 - Small bowel fistula complicating perforated appendicitis: successful treatment with tissue adhesive
from Section 4 - Vascular and interventional
Published online by Cambridge University Press: 05 June 2014
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgment
- Section 1 Head and neck
- Section 2 Thoracic imaging
- Section 3 Cardiac imaging
- Section 4 Vascular and interventional
- Case 33 Lower extremity ischemia due to homocystinuria
- Case 34 Iatrogenic pathology masquerading as an artifact
- Case 35 Fibromuscular dysplasia
- Case 36 Traumatic vertebral arteriovenous fistulae
- Case 37 Colonic perforation during intussusception reduction
- Case 38 Juvenile nasopharyngeal angioma
- Case 39 Small bowel fistula complicating perforated appendicitis: successful treatment with tissue adhesive
- Case 40 Extrahepatic collateral arterial supply to hepatocellular carcinoma
- Case 41 Use of a curved needle to access an otherwise inaccessible abscess
- Case 42 Umbilical venous catheter malposition
- Case 43 Middle aortic syndrome
- Section 5 Gastrointestinal imaging
- Section 6 Urinary imaging
- Section 7 Endocrine - reproductive imaging
- Section 8 Fetal imaging
- Section 9 Musculoskeletal imaging
- Index
- References
Summary
Imaging description
A previously healthy 11-year-old girl presented to interventional radiology with a two-week history of lower abdominal pain and diarrhea without nausea, vomiting, or fever. One week into the course of her present illness, antibiotics were begun empirically when a pediatrician at a neighborhood medical convenience clinic saw the patient. Antibiotics were discontinued two days later when she saw her regular pediatrician. However, as she continued to have pain and subjective fever, the patient’s parents sought medical attention four days later. At that time, the patient’s temperature was 104.2 °F and her white blood cell count was 21 700 with a left shift. An ultrasound scan (Fig. 39.1) demonstrated a large pelvic fluid collection that was drained percutaneously with CT guidance (Fig. 39.2). Following drainage, the patient became afebrile and her leukocytosis resolved. She was discharged from the hospital with instructions on care of her drainage tube. A sinogram/abscessogram was performed two weeks and again five weeks following drainage. Both examinations showed that the abscess cavity had shrunk to the size of the pigtail catheter loop, but a persistent sinus tract leading from the cavity to the terminal ileum was present (Fig. 39.3a). As the patient refused to go to school with the drainage tube in place, it was decided to attempt to close the sinus tract with tissue adhesive (Fig. 39.3b–d). Following treatment, the patient returned to school and resumed other normal activities. However, at six weeks post-treatment, she presented with recurrent abdominal pain, leukocytosis, and fever. CT (Fig. 39.4) demonstrated recurrent appendicitis, and an appendectomy was performed at that time. There have been no problems since.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Pediatric ImagingVariants and Other Difficult Diagnoses, pp. 177 - 180Publisher: Cambridge University PressPrint publication year: 2014