Ultrasound-guided drainage of peritonsillar abscess by the emergency physician

Michael Blaivas, Daniel Theodoro, Sandeep Duggal

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

The diagnosis of peritonsillar abscess (PTA) poses a challenge to emergency physicians (EPs). The decision to perform an invasive procedure with potential complications is based on clinical judgment that is often inaccurate. Although there is some mention of intraoral ultrasound in otolaryngology practice, there is none in the emergency medicine (EM) literature. However, this bedside emergency application of ultrasonography has the potential to be of considerable use in EM practice, and could allow EPs who previously deferred blind needle aspiration of a potential abscess to perform the procedure themselves. We report the cases of 6 patients who presented with probable PTA and were evaluated with intraoral ultrasound at the bedside by an EP. All 6 patients then underwent needle aspiration. As diagnosed on ultrasound, 3 of the patients had negative aspirations and were diagnosed with peritonsillar cellulitis. Three others were found to have PTA, with 2 requiring real-time ultrasound needle guidance to accomplish abscess drainage after multiple failures with the blind approach.

Original languageEnglish
Pages (from-to)155-158
Number of pages4
JournalAmerican Journal of Emergency Medicine
Volume21
Issue number2
DOIs
StatePublished - Mar 2003

Keywords

  • Emergency medicine
  • Emergency ultrasonography
  • Peritonsillar abscess
  • Ultrasound-guided procedures

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