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Nonoperative management for intra-abdominal abscesses
F W Shuler1, C N Newman, P B Angood
1Department of Surgery, Georgia Baptist Medical Center, Atlanta, Georgia.
The American Surgeon
|March 1, 1996
Summary
Radiologically directed percutaneous drainage of intra-abdominal abscesses is effective for most patients, but complications and need for surgery occur in one-third. Specific abscess types and patient factors predict less successful outcomes.
Area of Science:
- Interventional Radiology
- Abdominal Surgery
- Infectious Disease Management
Background:
- Intra-abdominal abscesses frequently require drainage.
- Percutaneous drainage is a common minimally invasive approach.
- Evaluating institutional effectiveness of this procedure is crucial.
Purpose of the Study:
- To assess the effectiveness and complications of radiologically directed percutaneous drainage for intra-abdominal abscesses.
- To identify factors associated with successful or unsuccessful drainage.
- To determine the need for subsequent surgical intervention.
Main Methods:
- Retrospective review of 18 patients undergoing image-guided percutaneous abscess drainage.
- Analysis of abscess etiology, patient demographics, drainage duration, and hospital stay.
- Evaluation of complications, need for surgery, and factors predicting outcomes.
Main Results:
- Complete abscess resolution in 67% of patients.
- Six patients (33%) required surgery due to inadequate drainage or deterioration.
- Common complications included catheter issues (39%) and major events (11%).
Conclusions:
- Percutaneous drainage is technically feasible and successful in most cases but has frequent complications.
- Abscesses associated with diverticular disease, colon cancer, or in the left lower quadrant were less successful.
- Elevated leukocyte count or APACHE II score may indicate a need for earlier surgical consideration.