Percutaneous catheter drainage in retroperitoneal abscesses: a single centre’s 8-year experience

Abstract

Purpose We have investigated the technical and clinical success of percutaneous catheter drainage (PCD) in retroperitoneal abscesses and factors that may affect the outcome. Material and methods The study cohort included 45 patients (17 females and 29 males, with mean age of 56.3 years) that were treated between 2012 and 2020. Forty-seven abscesses were managed with PCD under ultrasonography, computed tomography, or fluoroscopy guidance. Patients’ demographics, lesion locations, predisposing factors, clini-cal presentation, etiology, radiological findings, technical factors, and outcome parameters were presented using exploratory and descriptive statistics. Results Abscesses were located in the psoas ( n = 25, 55.3%), renal-perirenal ( n = 7, 14.8%), and pararenal ( n = 14, 29.7%) compartments. The mean preprocedural volume was 263.3 (30-1310) ml. Pain (abdominal and back) (57.4%) and fever (17%) were the most frequent presenting symptoms. The most common predisposing factors were previous surgery ( n = 17, 36.1%) and diabetes mellitus ( n = 11, 25.5%). Clinical success was attained in 89.3% of abscesses (definitive treatment 72.3% and partial success 17.0%). There was a statistically significant difference between the iatrogenic and non-iatrogenic groups regarding clinical success ( p = 0.031). No mortality was encountered. The complication rate was 6.6% and were all minor. The average rate of recurrence was 10.6%. The mean time to catheter removal was 15.8 ± 13.2 days. Conclusions PCD is a safe and effective procedure in the treatment of retroperitoneal abscesses. Procedure-related mortality, morbidity, and complication rates are low. Underlying etiology is a significant factor affecting the outcome. Nevertheless, PCD may provide definitive treatment in the majority of patients.

Successful eradication of renal allograft abscess by CT-guided percutaneous pigtail drainage: A case report

“…[ 4 ] A recent research reported that the clinical success rate was 100% for renal-perirenal abscesses. [ 4 ]…”

“…[4] A recent research reported that the clinical success rate was 100% for renal-perirenal abscesses. [4] The initial diagnosis of our patient was a complicated UTI based on clinical symptoms and laboratory data. The initial abdomen CT scans found no abnormalities including urinary obstruction and urinary calculi.…”

“…Ultrasound-or CT-guided percutaneous catheter drainage, performed under local anesthesia, was accepted as the primary method of treatment in view of its low complication and mortality rate and high patient tolerability. [4] A recent research reported that the clinical success rate was 100% for renal-perirenal abscesses. [4] The initial diagnosis of our patient was a complicated UTI based on clinical symptoms and laboratory data.…”

“…[ 3 ] Ultrasound and computed tomography (CT) do not only provide early diagnosis but also guide percutaneous therapeutic interventions. [ 4 ] Ultrasound- or CT-guided percutaneous drainage is minimally invasive procedure associated with a high rate of success and a low complication rate. [ 5 ] Herein, we report the first case of a polymicrobial abscess caused by Escherichia coli and Proteus mirabilis in the renal allograft.…”

Elderly Patients Managed Non-Operatively with Abscesses of the Anorectal Region Have Five Times Higher Rate of Mortality Compared to Non-Elderly

“…A more specific potential cause of aging in mortality could possibly be due to advances of the disease process from an abscess to NSTI with perineum and retroperitoneal involvement. Increased age enhances the likelihood of these more deleterious types of abscesses in anal or rectal regions, which elevates the chance of mortality in patients [ 27 , 28 , 29 ]. These abscesses are relatively rarer compared to intraperitoneal abscesses and tend to have a delayed course of action, which leads to delayed diagnoses and improper drainage [ 9 , 29 ].…”