Lesser sac abscesses and fluid collections: drainage by transhepatic approach

Twelve abscesses and fluid collections in the lesser peritoneal sac were drained percutaneously using an access route across the intervening liver. This rather unusual access was chosen when other approaches were contraindicated because of surrounding colon, stomach, or spleen. All collections were drained successfully, and no specific complications such as hemorrhage, bile leak, or liver abscess occurred. Placement of an abscess drainage catheter should be done through the peripheral portion of the liver if possible. The technique offers a new, safe approach to percutaneous drainage of hitherto inaccessible collections.