Risks associated with intestinal perforation during experimental percutaneous drainage.
OBJECTIVE
The authors evaluated the complication rate of transgressing small or large bowel during intraperitoneal percutaneous catheter placement in an animal model.


METHODS
Twenty-four 8-F catheters were percutaneously placed through the small and large bowel of 12 pigs. In six animals, the catheters were left in place until autopsy, whereas in the remaining six animals, the catheters were withdrawn 5 days after insertion. Computed tomographic (CT) scans were performed on days 1 and 8 after catheter placement in pigs in which catheters were in place at time of autopsy, and on days 1, 5, and 8 in pigs in which catheters were removed.


RESULTS
CT results showed no abscess or peritoneal effusion, but a pneumoperitoneum was present in four animals whose signs resolved on subsequent studies. Autopsy was performed in all animals 9 days after catheter placement. No clinical complication occurred, and no significant biochemical changes were observed. At autopsy, no bowel leakage, peritonitis, or abscess was visible. Bowel and peritoneal adhesions were found around the catheter tract. There was no difference between the animals with catheters in place at the time of autopsy and the animals without catheters. There also was no difference between the group of animals with small or large bowel transgression.


CONCLUSIONS
This study suggests that traversing the intestine during percutaneous placement of an intra-abdominal catheter should not be considered an absolute contraindication when no other approach is available.
Petit
P
P
Department of Diagnostic Radiology, Montreal General Hospital, McGill University, Quebec, Canada.
Bret
P M
PM
Lough
J O
JO
Reinhold
C
C
D000005:Abdomen; D000818:Animals; D002404:Catheterization / Q000009:adverse effects; D004322:Drainage / Q000009:adverse effects*; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D007422:Intestines / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging / Q000209:etiology; D011677:Punctures / Q000009:adverse effects*; D011859:Radiography; D013552:Swine