title: Imaging-guided percutaneous needle aspiration or catheter drainage of neonatal liver abscesses: 14-year experience.
abstract: OBJECTIVE
  The purpose of our study was to review the clinical aspects and long-term outcomes of imaging-guided percutaneous aspiration or drainage of liver abscesses in neonates.
  
  
  METHODS
  We retrospectively reviewed the clinical and imaging records of eight neonates with liver abscesses referred for imaging-guided percutaneous aspiration or drainage, including one autopsy-proven case in whom the percutaneous aspiration or drainage was not performed. Clinical and imaging features, complications, and long-term follow-up results were assessed.
  
  
  RESULTS
  Eight neonates with liver abscesses were referred for imaging-guided percutaneous aspiration or drainage (five males, three females; age range, 7-100 days; weight, 610-3,400 g). Six were born prematurely (24-29 weeks of gestation). Six had a history of umbilical catheterization. All were clinically septic. All neonates received long-term i.v. antibiotics. Five neonates had solitary multiloculated abscesses (right lobe [n = 3], straddling both lobes [n = 2]), and three had solitary uniloculated abscesses (right lobe [n = 1] and left lobe [n = 2]). Imaging-guided drainage catheter insertion (n = 4), aspiration (n = 2), and aspiration followed by drainage catheter insertion (n = 1) were performed in seven neonates within 1 day after referral. Coagulase-negative Staphylococcus (4/8) was the most common organism isolated from blood and pus. There were no procedure-related complications. Catheter repositioning was required in one. Serial sonography (mean, 12.5 months) and clinical follow-up (mean, 20.7 months) showed complete clinical remission in seven cases. Three healed with calcification in the previous abscess site. Long-standing left portal vein thrombosis was seen in two cases.
  
  
  CONCLUSIONS
  Neonatal liver abscess is associated with good long-term outcome and minimal complications when imaging-guided percutaneous aspiration or drainage is performed in conjunction with long-term antibiotic coverage.
authors.affiliation: Division of Image Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, ON M5G 1X8, Canada.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Christopher
authors.initials: C
authors.lastname: Tomlinson
authors.forename: Michael
authors.initials: M
authors.lastname: Temple
authors.forename: Joao
authors.initials: J
authors.lastname: Amaral
authors.forename: Bairbre L
authors.initials: BL
authors.lastname: Connolly
mesh_terms: D001424:Bacterial Infections / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002404:Catheterization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D008100:Liver Abscess / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D013396:Suction / Q000379:methods*; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D014463:Ultrasonography