Percutaneous Catheter Drainage of Abdominal Abscesses. A Five-Year Experience

Gerzof, Stephen G.; Robbins, AH; Johnson, W C; Birkett, Desmond H.; Nabseth, D C

doi:10.1016/s0022-5347(17)54083-5

Cited by 57 publications

(80 citation statements)

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“…The mean age and the Apache II score were not statistically significantly differ ent from those in group I. These patients did not undergo percutaneous drainage because there was evidence of anastomotic breakdown in 5 cases; 6 other patients were considered unsuitable for the nonoperative approach be cause of multiple abscesses [3], because the abscess was considered inaccessible [1], and because of the unstable medical condition [2]; for the last 6 patients, the percuta neous approach was not considered [3] and the abscesses were discovered unexpectedly at the time of the laparoto my [3]. The open drainages were most often performed by a laparotomy, usually through the original abdominal incision.…”

Section: Resultsmentioning

confidence: 87%

“…The outcome of secondary intra-abdominal abscesses has further bene fited from the introduction of the technique of percuta neous drainage under sonographic or CT guidance. Intro duced in the mid 1970s [8,9], various centers have reported success rates as high as 85-90% [1][2][3]. The tech nique is gaining increasing popularity.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous published re ports have stressed the high success rate of this technique in expert hands as well as other advantages including reduced morbidity and the avoidance of major surgical interventions [1][2][3]. However, it is not clear whether these exceptional results can be reproduced elsewhere.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous and Surgical Management of Infra-Abdominal Abscess: Complements or Rivals

Auguste¹,

Westerband²,

Wise³

1993

Dig Surg

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To compare radiographically guided percutaneous drainage (PD) to surgical drainage (SD), 33 consecutive cases of postoperative intra-abdominal abscesses were reviewed. PD used in 16 patients had a success rate of 81 % and a 6% mortality rate. SD used in 17 patients had a success rate of 83% and a 12% mortality rate. Hospital stays following PD and SD were comparable. PD is as safe and effective as surgical drainage and its indications are likely to increase as more skill is being acquired by the interventional radiologists, better equipment is becoming available and the surgeons become more open to this technique, reserving SD for percutaneously inaccessible abscesses and certain cases of free anastomotic ruptures.

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Section: Resultsmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous and Surgical Management of Infra-Abdominal Abscess: Complements or Rivals

Auguste¹,

Westerband²,

Wise³

1993

Dig Surg

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show abstract

“…The result is that most patients who previously required surgical drainage and debridement for life-threatening infections can have these sources of infection drained with minimally invasive techniques. For nearly 90% of such patients, the needle-or catheter-based intervention will be the only treatment necessary [14,15]. Uniloculated collections with no fistulous connection to the gastrointestinal tract or bronchial tract are likely to be resolved by percutaneous drainage.…”

Section: Percutaneous Abscess Drainagementioning

confidence: 99%

Imaging for Infection: From Visualization of Inflammation to Visualization of Microbes

Ady

Fong²

2014

Surgical Infections

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Background: With the development of high-resolution cross-sectional imaging, anatomic identification of most areas of infection has become routine. Imaging a site of infection allows for diagnosis and treatment. In the past, molecular imaging for infection involved mainly the use of radiolabeled leukocytes for functional targeting at infection sites. With the recent development of functional nuclear imaging, bacterial and viral metabolism can also be imaged directly for potential identification of early infection. Methods: Review of pertinent English-language literature. Results: Cross-sectional imaging is used routinely to identify and treat sources of infection in patients with fever, leukocytosis, or unexplained hemodynamic instability. Although ultrasound is preferred for the identification of biliary or hepatic sepsis, computed tomography (CT) has proved to be accurate for the identification and treatment of intra-abdominal fluid collections and abscesses. Biologic imaging is a non-invasive technique that identifies sites of infection in cases in which no definite abnormality is identified via cross-sectional imaging. This is made possible by imaging the accumulation of radioisotopes that have been attached to white blood cells or glucose. Biologic imaging is useful for the identification of anatomic sites where there is inflammation or high metabolic demand. However, a drawback of biologic imaging is that it is not specific for infection. Techniques that image microbes directly increase the specificity of imaging results significantly and can be used to quantify and track infectious processes. For example, radiolabeling of antimicrobial proteins and antibiotics is one technique that has been demonstrated to identify areas of infection accurately in animals but is not currently being used clinically in humans. With the advent of gene therapy, many researchers are inserting the herpes viral thymidine kinase gene into both viruses and bacteria. This allows for tracking of the infectious process by imaging the accumulation of radiolabeled thymidine analogues. Conclusion: This review summarizes standard imaging for infection as it is currently practiced clinically. We will also explore the promising new methods of microbial imaging that are likely to become standards in clinical care in the near future.

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“…Gerzof et al, reported that aspiration under US guide is mandatory either as a diagnostic tool or even therapeutic in certain situations. 13 Aspiration is accurate, rapid and safe for the diagnosis of abdominal collections. 4 …”

mentioning

confidence: 99%

Diagnostic peritoneal fluid aspiration: a simple maneuver to diagnose a major question: a prospective study surgical point of view

et al. 2017

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Background: A variety of fluids can accumulate in the peritoneal and pelvic cavities including ascites, blood, pus, bile, urine, lymph, cerebral spinal fluid, and mucin. The appearance of some of these fluids by imaging may suggest a specific etiology, but a diagnostic aspiration must be performed in the majority of cases. This review aims to assess critically the value of peritoneal fluid analysis in the diagnosis.Methods: There was prospectively evaluated 80 patients presented with intraperitoneal fluid collection at Sohag University Hospital from July 2016 till July 2017. Physical, chemical, bacteriological and cytological properties of the aspirated peritoneal fluid was studied.Results: The study included 80 patients with intra-peritoneal collection of surgical importance (due to trauma, inflammation, malignancy). Diagnostic aspiration from intra-abdominal collection was routinely done in all cases giving the following results: 20 cases (25%) showed blood in the aspirate, 18 cases (22.5%) showed pus, 11 cases (13.75%) showed bile stained fluid, 9 cases (11.25%) showed gastric contents, 8 cases (10%) showed serosangenous aspirate, 7 cases (8.75%) showed clear fluid aspirate, 4 cases (5%) showed turbid fluid and 3 cases (3.75%) showed small intestinal contents.Conclusions: Diagnostic aspiration from intraperitoneal fluid collection is considered a simple available test that helps in diagnosis of major problematic cases.

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Percutaneous Catheter Drainage of Abdominal Abscesses. A Five-Year Experience

Cited by 57 publications

References 0 publications

Percutaneous and Surgical Management of Infra-Abdominal Abscess: Complements or Rivals

Percutaneous and Surgical Management of Infra-Abdominal Abscess: Complements or Rivals

Imaging for Infection: From Visualization of Inflammation to Visualization of Microbes

Diagnostic peritoneal fluid aspiration: a simple maneuver to diagnose a major question: a prospective study surgical point of view

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