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Percutaneous Abscess Drainage

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Non-Vascular Interventional Radiology of the Abdomen

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Abstract

Image-guided percutaneous abscess drainage (PAD) ­represents a major contribution by the field of ­interventional radiology to patient care [1]. Since the 1980s, it has evolved to become a well-established, minimally invasive procedure for the treatment of infected fluid collections in the abdomen and pelvis [2–6]. This chapter discusses the indications, techniques, and complications of PAD.

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References

  1. Ibele A, Heise C. Diverticular disease: update. Curr Treat Options Gastroenterol. 2007;10(3):248–56.

    Article  PubMed  Google Scholar 

  2. Al-Hilli Z, Prichard R, Roche-Nagle G, Deasy J, Mcnamara D. Iliopsoas abscess: a re-emerging clinical entity not to be forgotten. Ir Med J. 2009;102(2):58–60.

    PubMed  CAS  Google Scholar 

  3. Eberhardt J, Kiran R, Lavery I. The impact of anastomotic leak and intra-abdominal abscess on cancer-related outcomes after resection for colorectal cancer: a case control study. Dis Colon Rectum. 2009;52(3):380–6.

    Article  PubMed  Google Scholar 

  4. Tasar M, Ugurel M, Kocaoglu M, Saglam M, Somuncu I. Computed tomography-guided percutaneous drainage of splenic abscesses. Clin Imaging. 2004;28(1):44–8.

    Article  PubMed  Google Scholar 

  5. Gerzof SG, Robbins A, Johnson W, Birkett D, Nabseth D. Percutaneous catheter drainage of abdominal abscesses: a five-year experience. N Engl J Med. 1981;305(12):653–7.

    Article  PubMed  CAS  Google Scholar 

  6. Zerem E, Hadzic A. Sonographically guided percutaneous ­catheter drainage versus needle aspiration in the management of pyogenic liver abscess. AJR Am J Roentgenol. 2007;189(3):W138–42.

    Article  PubMed  Google Scholar 

  7. Lee DH, Kim GC, Ryeom H, Kim JY, Kang D. Percutaneous paracoccygeal catheter drainage of deep pelvic abscesses using a combination of sonographic and fluoroscopic guidance. Abdom Imaging. 2008;33(5):611–4.

    Article  PubMed  Google Scholar 

  8. Carmody E, Thurston W, Yeung E, Ho CS. Transrectal drainage of deep pelvic collections under fluoroscopic guidance. Can Assoc Radiol J. 1993;44(6):429–33.

    PubMed  CAS  Google Scholar 

  9. Buecker A, Neuerburg J, Adam G, Nolte-Ernsting CC, Hunter D, Glowinski A, et al. MR-guided percutaneous drainage of abdominal fluid collections in combination with X-ray fluoroscopy: initial clinical experience. Eur Radiol. 2001;11(4):670–4.

    Article  PubMed  CAS  Google Scholar 

  10. Lohela P. Ultrasound-guided drainages and sclerotherapy. Eur Radiol. 2002;12(2):288–95.

    Article  PubMed  CAS  Google Scholar 

  11. Soyer P, Fargeaudou Y, Boudiaf M, Hamzi L, Rymer R. Percutaneous abdominopelvic interventional procedures using real-time CT fluoroscopy guidance at 21 mAs: an analysis of 99 consecutive cases. J Radiol. 2008;89(5 Pt 1):565–70.

    Article  PubMed  CAS  Google Scholar 

  12. Harisinghani M, Gervais D, Hahn P, Cho CH, Jhaveri K, Varghese J, et al. CT-guided transgluteal drainage of deep pelvic abscesses: indications, technique, procedure-related complications, and ­clinical outcome. Radiographics. 2002;22(6):1353–67.

    Article  PubMed  Google Scholar 

  13. Akinci D, Akhan O, Ozmen M, Karabulut N, Ozkan O, Cil BE, et al. Percutaneous drainage of 300 intraperitoneal abscesses with long-term follow-up. Cardiovasc Intervent Radiol. 2005;28(6):744–50.

    Article  PubMed  Google Scholar 

  14. Ho KS, Hyup KS, Han H. Soo Kim S., Yeon Lee J., Hwan Jeon Y. Image-guided transvaginal drainage of pelvic abscesses and fluid collection using a modified Seldinger technique. Acta Radiol. 2008;49(6):718–23.

    Article  Google Scholar 

  15. Seldinger S. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta radiol. 1953;39(5):368–76.

    Article  PubMed  CAS  Google Scholar 

  16. Gervais D, Brown S, Connolly S, Brec S, Harisinghani M, Mueller P. Percutaneous imaging-guided abdominal and pelvic abscess drainage in children. Radiographics. 2004;24(3):737–54.

    Article  PubMed  Google Scholar 

  17. Rao S, Hogan M. Trocar transrectal abscess drainage in children: a modified technique. Pediatr Radiol. 2009;39(9):982–4.

    Article  PubMed  Google Scholar 

  18. Mcgahan J, Wu C. Sonographically guided transvaginal or transrectal pelvic abscess drainage using the trocar method with a new drainage guide attachment. AJR Am J Roentgenol. 2008;191(5):1540–4.

    Article  PubMed  Google Scholar 

  19. O’neill MJ, Rafferty E, Lee SI, Arellano R, Gervais D, Hahn P, et al. Transvaginal interventional procedures: aspiration, biopsy, and catheter drainage. Radiographics. 2001;21(3):657–72.

    PubMed  Google Scholar 

  20. Butch RJ, Mueller P, Ferrucci JJ, Wittenberg J, Simeone J, White E, et al. Drainage of pelvic abscesses through the greater sciatic foramen. Radiology. 1986;158(2):487–91.

    PubMed  CAS  Google Scholar 

  21. Gervais D, Hahn P, O’Neill M, Mueller P. CT-Guided transgluteal drainage of deep pelvic abscesses in children: selective use as an alternative to transrectal drainage. AJR Am J Roentgenol. 2000;175(5):1393–6.

    PubMed  CAS  Google Scholar 

  22. Rose S, Kinney T, Roberts A, Valji K, Sanfeliz G, Miller F, et al. Endocavitary three-dimensional ultrasonographic assistance for transvaginal or transrectal drainage of pelvic fluid collections. J Vasc Interv Radiol. 2005;16(10):1333–40.

    Article  PubMed  Google Scholar 

  23. Sudakoff G, Lundeen S, Otterson M. Transrectal and transvaginal sonographic intervention of infected pelvic fluid collections: a complete approach. Ultrasound Q. 2005;21(3):175–85.

    Article  PubMed  Google Scholar 

  24. Men S, Akhan O, Koroglu M. Percutaneous drainage of abdominal abcess. Eur J Radiol. 2002;21(3):204–18.

    Article  Google Scholar 

  25. Saokar A, Arellano R, Gervais D, Mueller P, Hahn P, Lee SI. Transvaginal drainage of pelvic fluid collections: results, ­expectations, and experience. AJR Am J Roentgenol. 2008;191(5):1352–8.

    Article  PubMed  Google Scholar 

  26. Maher MM, Gervais D, Kalra M, Lucey B, Sahani D, Arellano R, et al. The inaccessible or undrainable abscess: how to drain it. Radiographics. 2004;24(3):717–35.

    Article  PubMed  Google Scholar 

  27. Loren I, Lasson A, Lundagards J, Nilsson A, Nilsson P. Transrectal catheter drainage of deep abdominal and pelvic abscesses using combined ultrasonography and fluoroscopy. Eur J Surg. 2001;167(7):535–9.

    Article  PubMed  CAS  Google Scholar 

  28. Granberg S, Gjelland K, Ekerhovd E. The management of pelvic abscess. Best Pract Res Clin Obstet Gynaecol. 2009;23(5):667–78.

    Article  PubMed  Google Scholar 

  29. Nielsen M, Torp-Pedersen S. Sonographically guided transrectal or transvaginal one-step catheter placement in deep pelvic and perirectal abscesses. AJR Am J Roentgenol. 2004;183(4):1035–6.

    PubMed  Google Scholar 

  30. Wroblicka J, Kuligowska E. One-step needle aspiration and lavage for the treatment of abdominal and pelvic abscesses. AJR Am J Roentgenol. 1998;170(5):1197–203.

    PubMed  CAS  Google Scholar 

  31. Kuligowska E, Keller E, Ferrucci J. Treatment of pelvic abscesses: value of one-step sonographically guided transrectal needle aspiration and lavage. AJR Am J Roentgenol. 1995;164(1):201–6.

    PubMed  CAS  Google Scholar 

  32. Petri A, Hohn J, Hodi Z, Wolfard A, Balogh A. Pyogenic liver abscess – 20 years’ experience. Comparison of results of treatment in two periods. Langenbecks Arch Surg. 2002;387(1):27–31.

    Article  PubMed  CAS  Google Scholar 

  33. Strong R, Fawcett J, Lynch S, Wall D. Hepatectomy for pyogenic liver abscess. HPB (Oxford). 2003;5(2):86–90.

    Article  CAS  Google Scholar 

  34. Ng SS, Lee JF, Lai PB. Role and outcome of conventional surgery in the treatment of pyogenic liver abscess in the modern era of minimally invasive therapy. World J Gastroenterol. 2008;14(5):747–51.

    Article  PubMed  Google Scholar 

  35. Rajak CL, Gupta S, Jain S, Chawla Y, Gulati M, Suri S. Percutaneous treatment of liver abscesses: needle aspiration ­versus catheter drainage. AJR Am J Roentgenol. 1998;170(4):1035–9.

    PubMed  CAS  Google Scholar 

  36. Ferral H, Quiroz Y, Ferrari F, Hernandez-Ortiz J. Hepatic abscess: image-guided percutaneous drainage. Technique and indications. Rev Invest Clin. 1991;43(4):299–304.

    PubMed  CAS  Google Scholar 

  37. Lee SH, Tomlinson C, Temple M, Amaral J, Connolly B. ­Imaging-guided percutaneous needle aspiration or catheter drainage of neonatal liver abscesses: 14-year experience. AJR Am J Roentgenol. 2008;190(3):616–22.

    Article  PubMed  Google Scholar 

  38. Kurland J, Brann O. Pyogenic and amebic liver abscesses. Curr Gastroenterol Rep. 2004;6:273–9.

    Article  PubMed  Google Scholar 

  39. Patterson J. Epidemiology of fungal infections in solid organ transplant patients. Transpl Infect Dis. 1999;1(4):229–36.

    Article  PubMed  CAS  Google Scholar 

  40. Yeh TS, Jan YY, Jeng L, Hwang T, Chao T, Chien R, et al. Pyogenic liver abscesses in patients with malignant disease: a report of 52 cases treated at a single institution. Arch Surg. 1998;133(3):242–5.

    Article  PubMed  CAS  Google Scholar 

  41. Mcdonald M. Pyogenic liver abscess: diagnosis, bacteriology and treatment. Eur J Clin Microbiol. 1984;3(6):506–9.

    Article  PubMed  CAS  Google Scholar 

  42. Stanley SJ. Amoebiasis Lancet. 2003;361:1025–34.

    Article  CAS  Google Scholar 

  43. Chavez-Tapia NC, Hernandez-Calleros J, Tellez-Avila FI, Torre A, Uribe M. Image-guided percutaneous procedure plus metronidazole versus metronidazole alone for uncomplicated amoebic liver abscess. Cochrane Database Syst Rev. 2009;21(1):CD004886.

    Google Scholar 

  44. Goessling W, Chung R. Amebic Liver Abscess. Curr Treat Options Gastroenterol. 2002;5:443–9.

    Article  PubMed  Google Scholar 

  45. Alvi AR, Kulsoom S, Shamsi G. Splenic abscess: outcome and prognostic factors. J Coll Physicians Surg Pak. 2008;18(12):740–3.

    PubMed  Google Scholar 

  46. Tung CC, Chen F, Lo CJ. Splenic abscess: an easily overlooked disease? Am Surg. 2006;72(4):322–5.

    PubMed  Google Scholar 

  47. Ferraioli G, Brunetti E, Gulizia R, Mariani G, Marone P, Filice C. Management of splenic abscess: report on 16 cases from a single center. Int J Infect Dis. 2008;13(4):524–30.

    Article  PubMed  Google Scholar 

  48. Zerem E, Bergsland J. Ultrasound guided percutaneous treatment for splenic abscesses: the significance in treatment of critically ill patients. World J Gastroenterol. 2006;12(45):7341–5.

    PubMed  Google Scholar 

  49. Thanos L, Dailiana T, Papaioannou G, Nikita A, Koutrouvelis H, Kelekis D. Percutaneous CT-guided drainage of splenic abscess. AJR Am J Roentgenol. 2002;179(3):629–32.

    PubMed  Google Scholar 

  50. Liu KY, Shyr Y, Su C, Wu C, Lee LY, Lui WY. Splenic abscess–a changing trend in treatment. S Afr J Surg. 2000;38(3):55–7.

    PubMed  CAS  Google Scholar 

  51. Cronan J, Amis EJ, Dorfman G. Percutaneous drainage of renal abscesses. AJR Am J Roentgenol. 1984;142:351–4.

    PubMed  CAS  Google Scholar 

  52. Gerzof S. Percutaneous drainage of renal and perinephric abscess. Urol Radiol. 1981;2(3):171–9.

    Article  PubMed  CAS  Google Scholar 

  53. Yen DH, Hu SC, Tsai J, Kao WF, Chern C, Wang L, et al. Renal abscess: early diagnosis and treatment. Am J Emerg Med. 1999;17(2):192–7.

    Article  PubMed  CAS  Google Scholar 

  54. Hung C, Liou J, Yan MY, Chang C. Immediate percutaneous ­drainage compared with surgical drainage of renal abscess. Int Urol Nephrol. 2007;39(1):51–5.

    Article  PubMed  Google Scholar 

  55. Shu T, Green J, Orihuela E. Renal and perirenal abscesses in patients with otherwise anatomically normal urinary tracts. J Urol. 2004;172(1):148–50.

    Article  PubMed  Google Scholar 

  56. Bakal C, Sacks D, Burke D, Cardella J, Chopra P, Dawson S, et al. Quality improvement guidelines for adult percutaneous abscess and fluid drainage. J Vasc Interv Radiol. 2003;14(9 Pt 2):S223–5.

    PubMed  Google Scholar 

  57. Beland MD, Gervais D, Levis D, Hahn P, Arellano R, Mueller P. Complex abdominal and pelvic abscesses: efficacy of adjunctive tissue-type plasminogen activator for drainage. Radiology. 2008;247(2):567–73.

    Article  PubMed  Google Scholar 

  58. Haaga J, Nakamoto D. Computed Tomography-guided Drainage of Intra-abdominal Infections. Curr Infect Dis Rep. 2004;6(2):105–14.

    Article  PubMed  Google Scholar 

  59. Diamond I, Wales P, Connolly B, Gerstle T. Tissue plasminogen activator for the treatment of intraabdominal abscesses in a neonate. J Pediatr Surg. 2003;38(8):1234–6.

    Article  PubMed  Google Scholar 

  60. Mueller P, Vansonnenberg E. Interventional radiology in the chest and abdomen. N Engl J Med. 1990;322(19):1364–74.

    Article  PubMed  CAS  Google Scholar 

  61. Mueller P, Vansonnenberg E, Ferrucci JJ. Percutaneous drainage of 250 abdominal abscesses and fluid collections. Part II: current procedural concepts. Radiology. 1984;151(2):343–7.

    PubMed  CAS  Google Scholar 

  62. Vansonnenberg E, Mueller P, Ferrucci JJ. Percutaneous drainage of 250 abdominal abscesses and fluid collections. Part I: results, failures, and complications. Radiology. 1984;151(2):337–41.

    PubMed  CAS  Google Scholar 

  63. Oglevie S, Casola G, Vansonnenberg E, D’agostino H, Olaoide R, Fundell L. Percutaneous abscess drainage: current applications for critically ill patients. J Intensive Care Med. 1994;9(4):191–206.

    PubMed  CAS  Google Scholar 

  64. Wang I, Chen Y, Chen Y, Fang J, Hang C. Successful treatment of renal abscess with percutaneous needle aspiration in a ­diabetic patient with end stage renal disease undergoing hemodialysis. Ren Fail. 2003;25(4):653–7.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA

    Ronald S. Arellano MD

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  1. Ronald S. Arellano MD
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Correspondence to Ronald S. Arellano MD .

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Arellano, R.S. (2011). Percutaneous Abscess Drainage. In: Non-Vascular Interventional Radiology of the Abdomen. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7732-8_3

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  • DOI: https://doi.org/10.1007/978-1-4419-7732-8_3

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