Endoscopic ultrasound‐guided pelvic abscess drainage (with video)

Holt, Bronte A.

doi:10.1002/jhbp.150

Cited by 18 publications

(6 citation statements)

References 21 publications

(26 reference statements)

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“…The recurrence rate found in the study (5.4 %, 2/37) is consistent with that reported in the literature [18,29] and con- Surgery Surgery Surgery ▶ Fig. 3 Flow chart of outcomes of patients who underwent endoscopic ultrasound (EUS)-guided drainage of pelvic abscesses.…”

Section: Drainage Modality N (%)supporting

confidence: 88%

Long-term outcome of endoscopic ultrasound-guided pelvic abscess drainage: a two-center series

et al. 2017

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Endoscopic ultrasound (EUS)-guided pelvic abscess drainage has been reported but long-term data remain limited. This two-center study evaluated long-term outcome of EUS-guided pelvic abscess drainage. Between May 2003 and December 2015, 37 consecutive patients were treated for perirectal or perisigmoid abscesses via EUS-guided drainage using plastic or lumen-apposing metal stent (LAMS). Clinical success was defined as complete resolution of the abscess on follow-up computed tomography (CT) scan at 4 weeks with symptom relief. Long-term success was defined as abscess resolution without the need for surgery and without recurrence on long-term follow-up (> 12 months). Median abscess size was 60 mm (interquartile range 41 - 70). Causes were postsurgical (n = 31, 83.8 %) or secondary to medical conditions (n = 6, 16.2 %). EUS-guided drainage involved needle aspiration (n = 4), plastic stent placement (n = 29) or LAMS placement (n = 4 patients). Technical and clinical success was achieved in 37 patients (100 %; 95 % confidence interval [CI] 91 - 100) and 34 patients (91.9 %; 95 %CI 78 - 98), respectively (5 patients needed a second EUS-guided intervention within 14 days after drainage). One patient required surgery and one required best supportive care owing to persistent abscess. Early complications were perforation requiring surgery (n = 1), stent migration (n = 1), and rectal discomfort (n = 1). At a median follow-up of 64 months (IQR 19 - 81), two patients experienced abscess recurrence, at 3 and 12 months, respectively, and were treated surgically. Long-term success was achieved in 32 of 37 patients (86.5 %; 95 %CI 71 - 95).EUS-guided drainage of pelvic abscess is safe, has good long-term outcome, and should be considered as an alternative to percutaneous and surgical drainage.

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Section: Drainage Modality N (%)supporting

confidence: 88%

Long-term outcome of endoscopic ultrasound-guided pelvic abscess drainage: a two-center series

et al. 2017

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“…Several researchers have compared outcomes in terms of success and complication rates between different drainage methods [1,9,10]. It has been recently observed a positive trend towards endoscopic ultrasound-guided drainage because of higher clinical success, lower complication rates, less mortality related to the procedure and shorter hospital stay [9][10][11][12]. However, percutaneous drainage is still the preferred intervention when compared to surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Drainage of Abdominal Collections—An Analysis over 5 Years

Stan-Ilie

Plotogea

Rinja

et al. 2021

Gastroenterology Insights

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Introduction. Ultrasound-guided (US-guided) percutaneous drainage (PD) of abdominal collections represents the first-choice alternative to surgical intervention. The aim of our study was to assess the efficacy and safety of PD of visceral and non-visceral abdominal collections by reviewing our personal experience over a period of 5 years. Material and methods. The present study included 66 patients who underwent PD under ultrasound guidance. We analyzed clinical variables (collection size, catheter diameter, collection type, microbiological analysis, antibiotic regimens) along with the outcomes of the procedure. Results. Visceral collections were predominant, encompassing 38 hepatic abscesses and 1 splenic hematoma. Microbiological analysis showed that the majority (54%) were monomicrobial. The most encountered pathogens were Klebsiella pneumoniae and Escherichia coli. Technical success was achieved in all cases and clinical success was observed in 84.6% of the cases. No immediate procedural complications were detected. There were 6 patients who needed reinterventions, either by catheter replacement or by surgical treatment. The mortality rate was 4.5%, due to patients’ poor overall status and oncological comorbidities. Conclusions. Percutaneous drainage under ultrasound guidance is a safe and effective procedure in the management of abdominal collections.

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“…139,140 Postoperative leakage in the non-IBD population has been shown to be successfully managed endoscopically using endoclips, endoloops, fully covered SEMSs, and recently full-thickness closure using over-the-scope clips. 125,127,[141][142][143][144] These principles could be extrapolated to the IBD population, although further studies are needed.…”

Section: Pouchitismentioning

confidence: 98%

Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease

Tharian

George

Navaneethan

2016

Inflammatory Bowel Diseases

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The role of endoscopy in inflammatory bowel disease (IBD) has grown over the last decade in both diagnostic and therapeutic realms. It aids in the initial diagnosis of the disease and also in the assessment of the extent and severity of disease. IBD is associated with development of multiple complications such as strictures, fistulae, and colon cancers. Endoscopy plays a pivotal role in the diagnosis of colon cancer in patients with IBD through incorporation of chromoendoscopy for surveillance. In addition, endoscopic resection with surveillance is recommended in the management of polypoid dysplastic lesions without flat dysplasia. IBD-associated benign strictures with obstructive symptoms amenable to endoscopic intervention can be managed with endoscopic balloon dilation both in the colon and small intestine. In addition, endoscopy plays a major role in assessing the neoterminal ileum after surgery to risk-stratify patients after ileocolonic resection and assessment of a patient with ileoanal pouch anastomosis surgery and management of postsurgical complications. Our article summarizes the current evidence in the role of endoscopy in the diagnosis and management of complications of IBD.

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Endoscopic ultrasound‐guided pelvic abscess drainage (with video)

Cited by 18 publications

References 21 publications

Long-term outcome of endoscopic ultrasound-guided pelvic abscess drainage: a two-center series

Long-term outcome of endoscopic ultrasound-guided pelvic abscess drainage: a two-center series

Ultrasound-Guided Percutaneous Drainage of Abdominal Collections—An Analysis over 5 Years

Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease

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