The infectious complications of interventional radiology based procedures in gastroenterology and hepatology

Many interventional radiology (IR) procedures are used to manage gastroenterological and hepatobiliary diseases. One of the most common complications of any IR procedure is infection.

Literature published in English from January 1960 to August 2010 pertaining to the infectious complications of IR in gastroenterology and hepatology patients was examined by electronic search (Medline and the National Library of Medicine, Embase and the Cochrane Library).

Percutaneous transhepatic cholangiogram (PTC) and biliary drainage, trans-arterial chemoembolization (TACE), transjugular intrahepatic portosystemic shunting (TIPS), imaged guided drainage of an intra-abdominal abscess and radiologically inserted gastrostomy (RIG) are the most common IR procedures performed for gastroenterology and hepatology patients. Procedures such as PTC have a high rate of infection. Infectious complications of TACE and TIPS are uncommon but when they occur, they can be devastating. RIG procedures are also rarely complicated by infection and such infections are generally mild. Use of prophylactic antibiotics is recommended for most of the above procedures.

The increased availability of IR based gastrointestinal and hepatobiliary techniques means that their related infectious complications will inevitably become more common. It is vital that clinicians be aware of the aetiology, timing and treatment of any potential infections in the peri-procedure period.