Therapeutic impact of CT-guided percutaneous catheter drainage in treatment of deep tissue abscesses

Abstract

Combination therapy of CT-guided percutaneous drainage and antibiotics is the first-line treatment for abscesses. Its effectiveness has been demonstrated. However, the therapeutic impact of this procedure for infection treatment has never been reported. We retrospectively analyzed all 47 patients who received CT-guided percutaneous drainage for infection treatment. Patients' characteristics, pathogens isolated, antibiotics administered, technical and clinical outcomes, complications related to this procedure and therapeutic impacts were investigated. Patients were 26 males and 21 females. The mean age was 63.5 years (±18.7). The diseases targeted were 19 retroperitoneal abscesses, 18 intra-abdominal abscesses, three pelvic abscesses, and seven others. As for technical outcomes, all of the 54 procedures (100%) were successful. As for clinical outcomes, 44 (93.6%) were cured and three patients (6.4%) died. No complications related to this procedure were found in this study. A total of 42 patients (88%) had a change in the management of their infection as a result of CT-guided percutaneous drainage, such as selection and discontinuation of antibiotics. In conclusion, CT-guided percutaneous drainage is a safe and favorable procedure in the treatment of deep tissue abscesses. Therapeutic impact of these procedures helped physicians make a rational decision for antibiotics selection.

Effectiveness and Therapeutic Impact of CT-Guided Percutaneous Drainage for Deep Neck Abscesses

“…The main advantages of this closed drainage system are the superior and persistent negative pressure for drainage, prevention of contamination in the surgical dressing, and easy management for nursing [19]. We obtained positive cultures in 82.8% of cases, which is consistent with other studies where positive cultures ranged from 56.3% -85.7% of deep neck abscesses cases [1] [11] [20]. Streptococcus species were found in the majority of cases (48.2%), which is also consistent with other studies of deep neck abscesses [21] [22].…”

Biliary injuries after pancreatic surgery: interventional radiology management

“…Imaging-guided techniques of percutaneous abscess drainage (PAD) lead to minimal tissue trauma and low morbidity and mortality rates (40). PAD are considered the first line treatment in both the paediatric and adult patients, in the absence of indications for immediate surgery (2,(41)(42)(43). Ultrasound, CT, and fluoroscopy are the imaging modalities most frequently used for PAD.…”

“…Ultrasound, CT, and fluoroscopy are the imaging modalities most frequently used for PAD. The choice of image guidance is individualized for each case based on abscess location, patient factors, operator experience and preference, and equipment availability (42)(43)(44). Ultrasound guidance is a real-time imaging technique and it is the method of choice in superficial abscesses, where there is a low risk of damage vascular structures, bowel, or pleural cavity (2).…”

“…The complication rate shown in literature is 2.5% (41). When PAD fails for the presence of septations or highly viscous contents, thrombolytic agents may be used to facilitate complete evacuation of abscess contents such as intracavitary urokinase in adults, tissue type plasminogen activator in paediatric patients (42)(43)(44). Catheter removal may be considered when the patient is clinically improved and no longer feverish, and catheter output has decreased to <10-15 mL/day.…”

“…These risks were: predisposing pathological conditions (risk 2.4 times higher than patients with other causes of abscess), presence of multiple abscesses (risk 2.5 times higher than patients with a single abscess), drainage removal with continuous daily production ≥15 mL/d (risk 4.1 times higher than those with lower drainage drain) (45) . Success rate for CT-guided PAD ranges from 75.7-86.9% and 100%, with only a few patients requiring new operative drainage (5,6,8,13,43,47). Sohn et al [2003] preformed PAD procedures on 84 patients with postoperative intraabdominal abscesses.…”