The role of invasive sonography in the differential diagnosis and treatment of intraabdominal fluid collections.
Sixty-nine ultrasound-guided interventions (23 punctures and 46 drainages) were performed on 51 patients with the suspicion of intraabdominal abscess or another type of fluid collection in a prospective-controlled study. Of the procedures, 58.8% were carried out following surgery, while in 41.2% the indication were not related to prior surgical intervention. Repeated procedures were done in 10 patients. In the group of punctures the procedure was therapeutic in 3 cases and diagnostic in 16 patients. The drainage was technically successful in 92.7%. The drain was displaced or blocked in 27% (n = 10), but reinterventions were necessary in only 5 cases for this reason. The total number of redrainages was 18.9%. The percutaneous (pc) drainage was insufficient in 8 patients (21.6%), all these patients were operated on. 62.2% of the patients recovered after pc drainage, 13.5% following redrainage (total 75.5%). In 8.1% of the cases after pc drainage and in 5.4% after pc redrainage open surgery became necessary. There was only one complication due to the procedure. Seven patients (14.3%) died of the disease which indicated the procedure. There were no fatal outcomes on the account of the intervention. Ultrasound-guided puncture is a suitable method to indicate or contraindicate open surgery in the case of intraabdominal fluid collection. The diagnostic puncture may be followed by sonographically guided drainage or in selected cases by therapeutic puncture, but if the pc drainage is insufficient, open surgery should be performed in time.
Regöly-Mérei
J
J
Third Surgical Department of Semmelweis University Medical School, Budapest, Hungary.
Ihász
M
M
Szeberin
Z
Z
Záborszky
A
A
D000005:Abdomen / Q000000981:diagnostic imaging*; D018784:Abdominal Abscess / Q000000981:diagnostic imaging* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001826:Body Fluids; D003937:Diagnosis, Differential; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011677:Punctures; D018084:Ultrasonography, Interventional