Liver Abscesses: Factors That Influence Outcome of Percutaneous Drainage

Haider, Steffen J.; Tarulli, Massimo; McNulty, Nancy J.; Hoffer, Eric K.

doi:10.2214/ajr.16.17713

Cited by 34 publications

(33 citation statements)

References 27 publications

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“…The treatment is based on antibiotherapy according to antibiogram and drainage or surgery [6]. All were treated with antibiotic therapy, along with percutaneous drainage (44.4% (44 cases)); and surgical drainage (12.1% (12 cases)).…”

Section: Discussionmentioning

confidence: 99%

“…The treatment is based on antibiotherapy and drainage. Surgery remains irst-line treatment of patients who present with abscess rupture, peritonitis, or a concomitant surgical condition but is otherwise reserved for failure of percutaneous drainage [6]. The percutaneous drainage could be an effective, and perhaps superior, alternative for treating PLA.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Pyogenic Liver Abscesses

Alonso¹

2018

Ann Clin Gastroenterol Hepatol

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Background: Pyogenic liver abscesses (PLA) are frequent in immunosuppressed patients. We review the characteristics of patients with PLA at a tertiary academic Spanish hospital in Asturias. Methods: A retrospective observational study for 10 years, between 2006-2015. Epidemiological, clinical, analytical characteristics, treatment and hospital stay of the patients with PLA were analyzed. Results: 99 patients, 62 (62.6%) men, with age ≥65 years (72.7%). The most frequent etiology was: Biliary (40%), postsurgical (15%) and intestinal origin (11%). The most frequent clinical signs were fever, showing signifi cant differences, abdominal pain (p=0.001) and nausea (p=0.02) between biliary PLA and the rest of the PLA. Microbiological results were confi rmed in 63% (62 cases). All were treated with antibiotic therapy, along with percutaneous drainage (44.4% (44 cases)); and surgical drainage (12.1% (12 cases)). The overall mean stay was 23.1 days without signifi cant differences between those treated with percutaneous drainage or surgical drainage. Conclusions: PLA predominate in patients ≥65 years. Biliary PLA are the most frequent, diagnosed at an older age than the intestinal PLA (p=0.005).-The treatment is based on systemic antibiotherapy and percutaneous drainage, especially in PLA only >5cm (p=0.019)-There are no signifi cant differences in average stay of patients treated with percutaneous drainage or surgical drainage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analysis of Pyogenic Liver Abscesses

Alonso¹

2018

Ann Clin Gastroenterol Hepatol

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“…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. In univariate and multivariate analyses, three independent variables were associated with a significantly lower rate of primary success of inserted PAD (45). 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) .…”

Section: Intraabdominal Abscessmentioning

confidence: 97%

“…In univariate and multivariate analyses, three independent variables were associated with a significantly lower rate of primary success of inserted PAD (45). 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).…”

Section: Intraabdominal Abscessmentioning

confidence: 97%

“…PAD may be performed using the Seldinger technique or the trocar technique, after subcutaneous administration of anaesthesia and IV moderate sedation. The Seldinger technique is a multistep procedure in which dilation and drain placement are performed after proper needle placement (2,41,42,44,45). The trocar technique is a monophasic procedure that is performed with a coaxial needle and drainage system.…”

Section: Intraabdominal Abscessmentioning

confidence: 99%

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Biliary injuries after pancreatic surgery: interventional radiology management

Angileri¹,

Gorga²,

Tortora³

et al. 2019

Gland Surg

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Bile duct injuries are among the most feared complications after pancreatic surgery. Most of these surgical complications are related to iatrogenic injuries and include bile leakage, biliary duct obstruction or stricture and infection. A wide range of Interventional Radiology treatment options are currently available. The options include percutaneous transhepatic cholangiography (PTC), percutaneous transhepatic biliary drainage (PTBD), percutaneous balloon dilatation and stenting, image-guided percutaneous abscess drainage. The purpose of this review is to describe the current evidence in this continuously evolving field.

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Delayed bleeding complication due to internal mammary artery injury after ultrasound‐guided percutaneous catheter drainage for liver cyst infection

Arai

Masuda

Nakano

et al. 2020

Acute Medicine & Surgery

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Background: Ultrasound-guided percutaneous catheter drainage (PCD) is widely accepted as a primary treatment for pyogenic liver abscess. Severe PCD-related complications have been reported; however, delayed bleeding complications due to internal mammary artery injury are unknown. Case Presentation: An 84-year-old man undergoing hemodialysis owing to chronic kidney disease due to focal segmental glomerulosclerosis was admitted to our hospital for liver cyst infection. Ultrasound-guided PCD was carried out through the normal liver at the upper abdominal midline at the level of the sixth intercostal space. Two days later, an abdominal hematoma occurred at the puncture site. Contrast-enhanced computed tomography revealed extravasation of the distal right internal mammary artery, which was successfully treated with percutaneous coil embolization. Conclusion: Internal mammary artery injury should be considered as a differential diagnosis when a progressing hematoma develops after PCD.

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Liver Abscesses: Factors That Influence Outcome of Percutaneous Drainage

Abstract: PCD was effective first-line treatment of complicated pyogenic liver abscesses, which often require catheter adjustment and salvage drainage procedures to reliably achieve success.

Cited by 34 publications

References 27 publications

Analysis of Pyogenic Liver Abscesses

Analysis of Pyogenic Liver Abscesses

Biliary injuries after pancreatic surgery: interventional radiology management

Delayed bleeding complication due to internal mammary artery injury after ultrasound‐guided percutaneous catheter drainage for liver cyst infection

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