Percutaneous drainage of abdominal abcess

Area of Science:

• Interventional Radiology
• Abdominal Surgery
• Medical Imaging

Background:

• Undrained abdominal abscesses historically have very high mortality rates (45-100%).
• Advances in image-guided percutaneous interventional techniques have dramatically improved patient outcomes.
• Percutaneous drainage is indicated for sepsis management and symptom relief from large fluid collections.

Purpose of the Study:

• To review the efficacy and application of image-guided percutaneous drainage for various abdominal abscesses.
• To highlight the advantages of percutaneous techniques over traditional surgical drainage.
• To discuss specific guidance modalities (ultrasound, CT) and approaches for different abscess locations.

Main Methods:

• Review of percutaneous drainage techniques for abdominal abscesses.
• Discussion of imaging guidance (ultrasound, CT) for catheter placement.
• Description of various percutaneous access routes for different anatomical locations (liver, pancreas, pelvis, kidney, psoas).

Main Results:

• Percutaneous drainage is effective and safe for liver, pancreatic, renal, perirenal, and psoas abscesses.
• Ultrasound guidance is sufficient for single liver abscesses; CT guidance is preferred for multiple abscesses.
• Specific percutaneous routes (transrectal, transvaginal, transgluteal) are detailed for pelvic abscess drainage.

Conclusions:

• Image-guided percutaneous drainage is a crucial, effective, and safe treatment modality for abdominal abscesses.
• It offers a less invasive alternative to surgery, improving patient outcomes and reducing mortality.
• Tailored approaches using specific imaging guidance and access routes optimize treatment for diverse abscess types.