Image-guided percutaneous treatment of abdominal-pelvic abscesses: A 5-year experience

被引:35
作者
Laganà D. [1 ]
Carrafiello G. [1 ]
Mangini M. [1 ]
Ianniello A. [1 ]
Giorgianni A. [1 ]
Nicotera P. [1 ]
Fontana F. [1 ]
Dionigi G. [2 ]
Fugazzola C. [1 ]
机构
[1] Vascular and Interventional Radiology, Department of Radiology, University of Insubria
[2] Department of General Surgery, University of Insubria
关键词
Abdominal percutaneous abscesses; Interventional radiology; Percutaneous drainage;
D O I
10.1007/s11547-008-0320-3
中图分类号
学科分类号
摘要
Purpose. This study was undertaken to evaluate the efficacy of image-guided percutaneous drainage in treating abdominal and pelvic abscesses. Materials and methods. From August 2001 to August 2006, 95 patients (49 men and 46 women; mean age 61 years, range 25-92) with 107 abscesses underwent image-guided percutaneous drainage. Thirty-one abscesses were retroperitoneal (9 peripancreatic, 17 perirenal, 5 pararenal), 37 intraperitoneal (2 in communication with the small bowel), 8 intrahepatic (2 in communication with the extrahepatic biliary system and 2 with the intrahepatic biliary system), 4 perisplenic and 27 pelvic (4 in communication with the large bowel). Seventy-one of 107 procedures were performed with ultrasonographic (US) guidance and 36/107 with computed tomography (CT) guidance. All procedures were carried out with 8-to 14-Fr pigtail drainage catheters. Results. Immediate technical success was achieved in 107/107 fluid collections. No major complications occurred. In 98/107 abscesses, we obtained progressive shrinkage of the collection (>50%) with consequent clinical success. In 9/107 cases, percutaneous drainage was unable to resolve the fluid collection. There were 12 cases of catheter displacement and six of obstruction. Conclusions. Percutaneous drainage is feasible and effective in treating abdominal and pelvic abscesses. It may be considered both as a preparatory step for surgery and a valuable alternative to open surgery. Failure of the procedure does not, however, preclude a subsequent surgical operation. © 2008 Springer-Verlag.
引用
收藏
页码:999 / 1007
页数:8
相关论文
共 34 条
[1]  
Altemeier W.A., Culbertsen W.R., Fullen W.D., Shook C.D., Intra-abdominal abscesses, Am J Surg, 125, pp. 70-79, (1973)
[2]  
Fry D.E., Garrison R.N., Heitsch R.C., Determinants of death in patients with intra-abdominal abscesses, Surgery, 88, pp. 517-523, (1980)
[3]  
Gazelle G.S., Mueller P.R., Abdominal abscesses. Imaging and intervention, Radiol Clin North Am, 32, pp. 913-932, (1994)
[4]  
Hinsdale J.G., Jaffe B.M., Reoperation for intraabdominal sepsis, Ann Surg, 199, pp. 31-36, (1984)
[5]  
Cinat M.E., Wilson S.E., Din A.M., Determinats for successfull percutaneous image-guided drainage of intra-abdominal abscess, Arch Surg, 137, pp. 845-849, (2002)
[6]  
Marano I., Mainenti P.P., Selva G., Computerized tomographyguided drainage of postoperative abdominal fluid collections, Radiol Med, 97, pp. 160-165, (1999)
[7]  
Gerzof S.G., Robbins A.H., Birkett D.H., Percutaneous catheter drainage of abdominal abscess guided by ultrasound and computed tomography, AJR Am J Roentgenol, 133, pp. 1-8, (1979)
[8]  
Leone A., Violino P., Ghirardo D., Role of computerized tomography in percutaneous drainage of acute infected necrotic-hemorrhagic pancreatitis, Radiol Med, 92, pp. 241-246, (1996)
[9]  
Lambiase R.E., Deyoe L., Cronan J.J., Percutaneous drainage of 335 consecutive abscesses: Results of primary drainage with 1-year follow-up, Radiology, 184, pp. 167-179, (1992)
[10]  
Schechter S., Eisentat T.E., Oliver G.C., Computerized scan-guided drainage of intra-abdominal abscesses. Preoperative and postoperative modalities in colon and rectal surgery, Dis Colon Rectum, 37, pp. 984-988, (1994)