title: CT-guided drainage of abdominal abscesses: hydrodissection to create access routes for percutaneous drainage.
abstract: OBJECTIVE
  The purpose of this article is to determine the clinical effectiveness of CT-guided injection of 0.9% saline solution into the retroperitoneal space to create access routes for imaging-guided percutaneous abscess drainage.
  
  
  METHODS
  Between January 2005 and December 2008, a radiology database was searched to identify patients who underwent CT-guided percutaneous drainage of abdominal abscesses using injection of 0.9% saline solution into the retroperitoneal space to displace vital structures and create access routes for percutaneous drainage. Patient sex and age and the cause, size, and location of the abscess were recorded. The volume of 0.9% saline solution used to displace the structures was recorded. Technical success of creating an access route and procedural success in completing percutaneous drainage were evaluated. Complications were recorded.
  
  
  RESULTS
  Twelve patients (three men and nine women; mean age, 57 years; range, 26-84 years) with 12 abscesses underwent CT-guided percutaneous abscess drainage after injection of 0.9% saline solution into the retroperitoneum to displace structures and create an access route for drainage. The structures displaced using this technique included the ascending colon (n = 4), descending colon (n = 3), sigmoid colon (n = 2), duodenum (n = 2), and stomach (n = 1). The mean volume of 0.9% saline solution used to displace vital structures was 225 mL (range, 60-250 mL). Technical success was achieved in all 12 cases (100%). Procedural success was achieved in 11 (92%) of 12 cases.
  
  
  CONCLUSIONS
  CT-guided injection of 0.9% saline solution into the retroperitoneal space is associated with a high technical success rate for displacing vital structures and creating a percutaneous access route for imaging-guided drainage of abdominal abscesses.
authors.affiliation: Department of Radiology, Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit St., White 270, Boston, MA 02114, USA. rarellano@partners.org
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Arellano
authors.forename: Debra A
authors.initials: DA
authors.lastname: Gervais
authors.forename: Peter R
authors.initials: PR
authors.lastname: Mueller
mesh_terms: D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012965:Sodium Chloride / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D012965:Sodium Chloride