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Percutaneous drainage of subphrenic abscesses
D van Gansbeke1, C Matos, M Gelin
1Department of Radiology, Hôpital Erasme, Free University of Brussels, Belgium.
The British Journal of Radiology
|February 1, 1989
Summary
Percutaneous drainage of subphrenic abscesses is effective, with 87% of patients achieving successful drainage. Key factors include anatomical knowledge, large catheters, and managing fistulas for optimal outcomes.
Area of Science:
- Interventional Radiology
- Surgical Gastroenterology
- Abdominal Imaging
Background:
- Subphrenic abscesses are serious complications often arising after abdominal surgery, biliary issues, trauma, or pancreatitis.
- Effective management is crucial to prevent morbidity and mortality.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous drainage for subphrenic abscesses.
- To identify critical factors for successful abscess management.
Main Methods:
- Retrospective analysis of 40 percutaneous drainage procedures in 37 patients.
- Procedures guided by duplex sonography and fluoroscopy, primarily using an angled subcostal approach.
- Insertion of large-bore drainage catheters (≥12 F) via the Seldinger technique.
Main Results:
- Clinical improvement observed in all 37 patients post-catheter insertion.
- Successful drainage achieved in 32 patients (87%) without major complications.
- Temporary benefit in 3 patients (8%) allowing for subsequent curative surgery.
Conclusions:
- Percutaneous drainage is a safe and effective treatment for subphrenic abscesses.
- Successful outcomes depend on understanding subphrenic anatomy, utilizing large-bore catheters, and managing associated fistulas.
- This minimally invasive approach offers a high success rate in managing complex intra-abdominal infections.