Abscess drainage with CT and ultrasound guidance

The technique of catheter drainage of abscesses, while appearing to be a departure from standard surgical tenets, in reality adheres to accepted principles of abscess management. In properly selected candidates, most abscesses are adequately and safely drained by catheter. Catheter drainage has the advantages of avoidance of general anesthesia, less morbidity, and lower cost when compared with that of surgical drainage. Since catheter drainage does not preclude surgical drainage, in appropriate candidates percutaneous drainage should be considered initially for definitive therapy. Ultrasonography and CT have become the preferred methods of detecting abdominal abscesses and also of guiding percutaneous catheter drainage. Real-time sonography has the advantages of being inexpensive, "portable," and able to provide simultaneous imaging during catheter placement. CT provides greater accuracy in guiding drainage of small, deep abscesses, more accurate delineation of the extent and location of the collection, and better definition of the relationship of abscesses to bowel and blood vessels.