Safety and Efficacy of Percutaneous CT-Guided Drainage in the Management of Abdominopelvic Abscess

Abstract

Background:Abdominopelvic fluid collection and abscess management and their outcomes have improved in the recent years due to innovation of the image-guided drainage technique and improvement of surgical proceduresObjectives:This study was undertaken to evaluate the efficacy of CT-guided percutaneous drainage in treating abdominopelvic abscesses.Patients and Methods:In this study, the data of 41 patients who had abdominal abscess or fluid collections, and underwent treatment by percutaneous CT-guided drainage were analyzed. Treatment was assessed by reduction of collection size, relief of symptoms and signs including abdominal pain and fever and imaging findings. Any morbidity such as wound infection, sepsis, hematoma formation or peritonitis was followed up to six months after the procedure.Results:The average age of the patients was 54 years (range 12 to 79), including 21 (51%) men and 20 (49%) women. The common signs and symptoms were pain (83%) and fever (80.5%). The most prevalent abdominal abscess etiology was previous surgery in 31 cases (75.5%). Abscess diameter ranged between 5 and 12 cm (mean, 7.8 cm). The average hospital stay was 8 days (4-15). Thirty five cases (86%) were successfully treated. Only one case (2.5%) developed complication (peritonitis) after the procedure.Conclusions:According to our findings, CT-guided percutaneous drainage is a safe and effective procedure in the treatment of abdominal abscess and fluid collection.

Biliary injuries after pancreatic surgery: interventional radiology management

“…The common signs and symptoms are abdominal pain (83%), fever (80.5%), chills and perspiration (56%). Undrained abdominal abscess has a high mortality rate between 45% and 100% (2).…”

“…Imaging-guided techniques of percutaneous abscess drainage (PAD) lead to minimal tissue trauma and low morbidity and mortality rates (40). PAD are considered the first line treatment in both the paediatric and adult patients, in the absence of indications for immediate surgery (2,(41)(42)(43). Ultrasound, CT, and fluoroscopy are the imaging modalities most frequently used for PAD.…”

“…The choice of image guidance is individualized for each case based on abscess location, patient factors, operator experience and preference, and equipment availability (42)(43)(44). Ultrasound guidance is a real-time imaging technique and it is the method of choice in superficial abscesses, where there is a low risk of damage vascular structures, bowel, or pleural cavity (2).…”

“…CT is the method of choice when US guidance does not seem safe enough (40). Contraindications to percutaneous catheter placement include an uncorrected coagulopathy, lack of a safe percutaneous access route and inability of the patient to cooperate (2,42,44).…”

“…Despite the improvements achieved in surgical techniques, biliary injuries remain a critical problem and a major cause of morbidity. The difficult location of the pancreas gland due to the presence of vital structures that surround it and the creation of a new anastomosis between the biliary and the gastrointestinal system, add complexity to pancreatic surgery (1)(2)(3)(4).…”