Abscess-Fistula Complexes: A Systematic Approach for Percutaneous Catheter Management

Area of Science:

• Gastroenterology
• Interventional Radiology
• Surgical Innovation

Background:

• Postprocedural abscess-fistula complexes present a significant clinical challenge.
• Effective management strategies are crucial for patient recovery and preventing complications.

Purpose of the Study:

• To evaluate a systematic catheter management approach for treating abscesses with enteric fistulae.
• The approach focuses on abscess evacuation and selective fistula tract cannulation.

Main Methods:

• Retrospective study of 27 patients with postprocedural abscess-fistula complexes.
• Percutaneous drainage of abscesses; selective catheter cannulation of enteric fistulae for high-output or recurrent cases.
• Utilized multiple catheters for viscous fluid or large collections (≥ 6 cm).

Main Results:

• Successful resolution of abscess-fistula complexes in 88.9% (24/27) of patients.
• High-output fistulae required more procedures (9.1 vs 6.1) but not significantly longer catheter duration.
• Cannulated fistulae had longer catheter duration (102.5 days) and more procedures (8.4).

Conclusions:

• The described catheter management strategy is effective for resolving most abscess-fistula complexes.
• Selective fistula tract cannulation may be beneficial for complex or high-output cases.
• This minimally invasive approach offers a promising alternative to surgery in selected patients.