ACR Appropriateness Criteria® on Percutaneous Catheter Drainage of Infected Fluid Collections

Lorenz, Jonathan M.; Funaki, Brian; Ray, Charles E.; Brown, Daniel B.; Gemery, John M.; Greene, Frederick L.; Kinney, Thomas B.; Kostelic, Jon K.; Millward, Steven F.; Nemcek, Albert A.; Owens, Charles; Reinhart, R. D.; Rockey, Don C.; Silberzweig, James E.; Vatakencherry, Geogy

doi:10.1016/j.jacr.2009.08.011

Cited by 22 publications

(29 citation statements)

References 44 publications

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“…There is a wide variety of prediction models referred to in the literature and used in different centers[14,15]. Adequate treatment must be provided according to patients’ general condition, offering alternative options, such as percutaneous, endoscopic or surgical treatment[4,16,17]. …”

Section: Background Datamentioning

confidence: 99%

“…A large pseudocyst size itself does not necessitate drainage, although pseudocysts > 6 cm persisting for > 6 wk tend to be symptomatic and have a low likelihood of resolution[11,12]. The American College of Radiology appropriateness criteria in 2009 recommend drainage of complicated pseudocysts ≥ 5 cm that are rapidly enlarging, obstructing, and infected[17]. According to the American College of Gastroenterology guidelines of 2013, asymptomatic pseudocysts and pancreatic or extrapancreatic necrosis regardless of size, location, or extension do not require intervention[5].…”

Section: Outcomes After Different Management Plansmentioning

confidence: 99%

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Management of patients after recovering from acute severe biliary pancreatitis

Dedemadi

Nikolopoulos

Kalaitzopoulos

et al. 2016

WJG

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Cholelithiasis is the most common cause of acute pancreatitis, accounting 35%-60% of cases. Around 15%-20% of patients suffer a severe attack with high morbidity and mortality rates. As far as treatment is concerned, the optimum method of late management of patients with severe acute biliary pancreatitis is still contentious and the main question is over the correct timing of every intervention. Patients after recovering from an acute episode of severe biliary pancreatitis can be offered alternative options in their management, including cholecystectomy, endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy, or no definitive treatment. Delaying cholecystectomy until after resolution of the inflammatory process, usually not earlier than 6 wk after onset of acute pancreatitis, seems to be a safe policy. ERCP and sphincterotomy on index admission prevent recurrent episodes of pancreatitis until cholecystectomy is performed, but if used for definitive treatment, they can be a valuable tool for patients unfit for surgery. Some patients who survive severe biliary pancreatitis may develop pseudocysts or walled-off necrosis. Management of pseudocysts with minimally invasive techniques, if not therapeutic, can be used as a bridge to definitive operative treatment, which includes delayed cholecystectomy and concurrent pseudocyst drainage in some patients. A management algorithm has been developed for patients surviving severe biliary pancreatitis according to the currently published data in the literature.

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Section: Background Datamentioning

confidence: 99%

Section: Outcomes After Different Management Plansmentioning

confidence: 99%

Management of patients after recovering from acute severe biliary pancreatitis

Dedemadi

Nikolopoulos

Kalaitzopoulos

et al. 2016

WJG

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“…Some studies have shown that small (<3 cm) abscesses can be treated with antibiotics alone, especially in cases without associated fistulas or in immunomodulator-naïve patients [6,7,8]. It is important to closely observe the clinical condition of the patient and to intervene in case of any deterioration.…”

Section: Treatment Options For Intra-abdominal Abscessesmentioning

confidence: 99%

Abdominal Abscess in Crohn's Disease: Multidisciplinary Management

Groof

Carbonnel

Buskens

et al. 2014

Dig Dis

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Crohn's disease (CD) is characterized by full-thickness inflammation of the bowel. For this reason, perforating complications such as intra-abdominal abscesses or fistulas are common. A concomitant intra-abdominal abscess with active CD of the small bowel is a challenging dilemma for gastroenterologists and surgeons. Since there is active and severe disease, this should be treated with immunosuppressive drugs. However, in the presence of an intra-abdominal abscess, immunosuppression can be dangerous. There are several treatment options for intra-abdominal abscesses in CD. Nowadays, the first-line treatment is antibiotic therapy with or without percutaneous drainage. Historically, patients were treated with surgical drainage. With the development of percutaneous drainage, treatment shifted to a more nonsurgical approach. Success rates for percutaneous drainage in the literature vary from 74 to 100%, and it is considered to be a relatively safe procedure. It has been reported that surgery can be avoided after successful percutaneous drainage in a variable number of patients (14-85%). If sepsis is controlled, CD medication should be started to prevent recurrence. It is important to monitor the effect upon CD lesions to avoid further perforating complications. Finally, an undrainable or small abscess can be treated with antibiotics alone, although high recurrence rates have been described with this approach. Patients with a concomitant stenosis, an enterocutaneous fistula or refractory active disease are likely to require surgery. Percutaneous drainage in combination with delayed surgery is useful to improve the patient's condition prior to surgery and is associated with less morbidity, a lower stoma rate and more limited resection. In conclusion, when feasible, percutaneous drainage and antibiotics should be the treatment of choice in patients with an intra-abdominal abscess in CD. If surgery is inevitable, this must be delayed to reduce postoperative septic complications and high stoma rates.

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“…Frequent imaging follow-up, which includes the acquisition of postdrainage computed tomography (CT) scans or ultrasound images, is typically required to monitor and assess the efficacy of catheter drainage (4)(5)(6). Imaging follow-up frequency is influenced by various factors, such as underlying cause, collection location and complexity, and any procedurerelated complications (5)(6)(7)(8).…”

mentioning

confidence: 99%

“…Because patients usually have a diagnostic CT examination before catheter placement, follow-up CT examinations have lower image quality (IQ) requirements and readily tolerate scan parameter modification to lower the radiation dose (4,13,14). The introduction of iterative reconstruction technique (IRT) algorithms in CT imaging has also enabled significant dose reductions while preserving IQ (15,16).…”

mentioning

confidence: 99%