Infected abdominal tumors: percutaneous catheter drainage.

Abstract

Sixteen patients underwent percutaneous catheter drainage of infected primary (n = 9) or metastatic (n = 7) abdominal tumors. Twelve of the patients improved clinically, as evidenced by defervescence and decrease or normalization of leukocytosis. Four patients did not respond to catheter drainage and required surgery. Three of the twelve who improved underwent operations for attempts at surgical cure or debulking of tumor volume despite an initial "good" response to percutaneous drainage. Of the nine patients who did not undergo surgery after percutaneous drainage, four underwent catheter removal after 5 weeks of drainage and had no recurrence of infection, two remained alive with the catheter in place up to 8 months and 1 year after drainage, and two died with the catheter in place. One patient had the catheter removed inadvertently after 3 weeks of drainage and had recurrences that required replacement of the catheter until his death. The major differences between drainage of necrotic tumors and drainage of standard abscesses were the need for surgery in the majority of the cases and the fact that patients needed the catheters for continued palliation until their death.

ACR Appropriateness Criteria® Radiologic Management of Infected Fluid Collections

“…For good surgical candidates, tumor resection is typically performed. For poor surgical candidates, the period of catheterization may be markedly prolonged or indefinite [46]. Despite this finding, patients with infected, inoperable tumors at risk for systemic infection may opt for PCD.…”

ACR Appropriateness Criteria Radiologic Management of Infected Fluid Collections

“…For good surgical candidates, tumor resection is typically performed. For poor surgical candidates, the period of catheterization may be markedly prolonged or indefinite [33]. Despite this finding, patients with infected, inoperable tumors at risk for systemic infection may opt for PCD.…”

Nonvascular Interventions of the Urinary Tract

“…Infected tumors also can be managed by PCD (24). Some pelvic fluid collections are approached via transvaginal, transrectal, transperineal, or transgluteal routes (25,26).…”

“…Basic techniques are similar to those of PCN and consist of puncture, guidewire insertion, tract dilation, and catheter placement (22)(23)(24) (Fig. 6).…”