Image Guided Percutaneous Drainage of Intra-Abdominal Collections

Abstract

Background: Intra-abdominal collections and abscesses are commonly encountered in surgical practice. They contribute to significant morbidity and mortality, hence, need to be addressed expeditiously. Percutaneous catheter drainage (PCD) is an important treatment modality that is now in vogue. Aim: This study was carried out to assess the outcomes of image guided PCD of intra-abdominal collections/ abscesses. Materials and Methods: This prospective study was carried out at a tertiary centre on patients who underwent image guided drainage of intra-abdominal collections/ abscesses from Jul 2014 to Dec 2016. Data was collected by following up the patients both clinically and radiologically. Results: 31 patients underwent PCD. Procedure was successful in 77.4%. Complete resolution was observed in all post-operative collections. Collections resolved after a single drainage procedure in 71% while the remaining 29% required multiple drainage procedures. Liver abscesses were the commonest, with multiple foci. Organisms were isolated in 13%, Escherichia coli being the commonest isolate. Higher leucocyte counts, lower levels of drain amylase and shorter duration of antibiotics were significantly associated with the success of the procedure. There were no complications other than an isolated case of biliary fistula following drainage of liver abscess. Ultrasonography was found to be at par with CT scan for PCD. Conclusion: Image guided PCD is a safe and efficacious procedure for the treatment of intra-abdominal collections and abscesses. It has a high success rate, especially in postoperative collections. The procedure has low morbidity and low complication rates. High leucocyte count, short duration of antibiotic exposure and low levels of drain fluid amylase are independent predictors of favourable outcome after percutaneous drainage.