Image-guided percutaneous treatment of abdominal-pelvic abscesses: a 5-year experience.
OBJECTIVE
This study was undertaken to evaluate the efficacy of image-guided percutaneous drainage in treating abdominal and pelvic abscesses.


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.
Laganà
D
D
Vascular and Interventional Radiology, Department of Radiology, University of Insubria, 21100 Varese, Italy. donlaga@gmail.com
Carrafiello
G
G
Mangini
M
M
Ianniello
A
A
Giorgianni
A
A
Nicotera
P
P
Fontana
F
F
Dionigi
G
G
Fugazzola
C
C
D018784:Abdominal Abscess / Q000000981:diagnostic imaging* / Q000628:therapy*; D000038:Abscess / Q000000981:diagnostic imaging* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
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