Abstract
Aim of the study
Oncological patients are particularly prone to the onset of septic complications such as abdominal abscesses. The aim of our study was to analyze clinical and microbiological data in a population of oncological patients, submitted to percutaneous ultrasound-guided drainage (PUD) for postoperative abdominal abscesses.
Patients and methods
Data from 24 patients operated on for neoplastic pathologies and treated with PUD for abdominal abscesses during the postoperative period were reviewed. In all cases cultural examination with antibiogram was performed.
Results
In 5 out of 24 patients (20.8%), the abdominal abscesses appeared after the discharge, with a mean hospital stay of 34.2 ± 24.9 days. In six out of 24 patients (25%) there were multiple abscesses localizations. The cultural examination was positive in 23 patients and negative only in one patient. Abscesses localized only in the upper abdominal regions had a significant prevalence of monomicrobial cultural examinations (57.1%) with respect to the results for abscesses placed in the lower abdominal regions, that were polymicrobial in 88.8% of cases (p = 0.027). An antibiogram demonstrated a stronger activity of beta-lactamines, chinolones, and glycopeptides with respect to aminogycosides, cephalosporins, and metronidazole.
Conclusions
In oncological patients, the planning of the empiric antibiotic therapy should be based on the anatomotopographic localization of the abdominal abscess and on the typology of the operation performed giving preference to beta-lactamines, chinolones and glycopeptides.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Jaffe T, Nelson R, DeLong D, Paulson E (2004) Practice patterns in percutaneous image-guided intraabdominal abscess drainage: survey of academic and private practice centers. Radiology 233(3):750–756
American College of Radiology (1999) Percutaneous catheter drainage of infected intraabdominal fluid collections. In: ACR Appropriateness Criteria. Reston, VA: American College of Radiology
Gazelle GS, Mueller PR (1994) Abdominal abscess. Imaging and intervention. Radiol Clin North Am 32:913–932
vanSonnenberg E, Ferrucci JT, Mueller PR, Wittenberg J, Simeone JF (1982) Percutaneous drainage of abscesses and fluid collections: technique, results, and applications. Radiology 142:1–10
Bouali K, Magotteaux P, Jadot A, Saive C, Lombard R, Weerts J, Dallemagne B, Jehaes C, Delforge M, Fontaine F (1993) Percutaneous catheter drainage of abdominal abscess after abdominal surgery: results in 121 cases. J Belg Radiol 76:11–14
vanSonnenberg E, Wing VW, Casola G, Coons HG, Nakamoto SK, Mueller PR, Ferrucci JT Jr, Halasz NA, Simeone JF (1984) Temporizing effect of percutaneous drainage of complicated abscesses in critically ill patients. AJR Am J Roentgenol 142:821–826
Bufalari A, Giustozzi G, Moggi L (1996) Postoperative intraabdominal abscesses: percutaneous versus surgical treatment. Acta Chir Belg 96:197–200
Lang EK, Springer RM, Glorioso LW 3rd, Cammarata CA (1986) Abdominal abscess drainage under radiologic guidance: causes of failure. Radiology 159:329–336
vanSonnenberg E, Mueller PR, Ferrucci JT Jr (1984) Percutaneous drainage of 250 abdominal abscesses and fluid collection. I. Results, failures, and complications. Radiology 151:337–341
Rothlin MA, Schob O, Klotz H, Candinas D, Largiader F (1998) Percutaneous drainage of abdominal abscesses: are large-bore catheters necessary? Eur J Surg 164:419–424
Lambiase RE, Deyoe L, Cronan JJ, Dorfman GS (1992) Percutaneous drainage of 335 consecutive abscesses: results of primary drainage with 1-year follow-up. Radiology 184:167–179
Cinat ME, Wilson SE, Din AM (2002) Determinants for successful percutaneous image-guided drainage of intra-abdominal abscess. Arch Surg 137:845–849
Shuler FW, Newman CN, Angood PB, Tucker JG, Lucas GW (1996) Nonoperative Management for intra-Abdominal Abscesses. Am Surg March 62:218–222
Hemming A, Davis NL, Robins RE (1991) Surgical versus percutaneous drainage of intra-abdominal abscess. Am J Surg 161:593–595
Malangoni MA, Shumate CR, Thomas HA, Richardson JD. (1990) Factors influencing the treatment of intra-abdominal abscesses. Am J Surg 159:167–171
Gerzof SG, Robbins AH, Johnson WC, Birkett DH, Nabseth DC (1981) Percutaneous catheter drainage of abdominal abscesses: A five-year experience. N Engl J Med 305:653–657
Christou NV, Turgeon P, Wassef R, Rotstein O, Bohnen J, Potvin M, the Canadian Intra-abdominal Infection Study Group (1996) Management of intra-abdominal infections. The case for intraoperative cultures and comprehensive broad-spectrum antibiotic coverage. Arch Surg 131:1193–1201
Men S, Akhan O, Koroglu M (2002) Percutaneous drainage of abdominal abscess. Eur J Radiol 43:204–218
Solomkin JS, Dellinger EP, Christou NV, Busuttil RW (1990) Results of a multicenter trial comparing imipenem/cilastatin to tobramycin/clindamycin for intra-abdominal infections. Ann Surg 212:581–591
Poenaru D, De Santis M, Christou NV (1990) Imipenem versus tobramycin-antianaerobe antibiotic therapy in intra-abdominal infectons. Can J Surg 33:415–422
Solomkin JS, Reinhart HH, Dellinger EP, Bohnen JM, Rotstein OD, Vogel SB, Simms HH, Hill CS, Bjornson HS, Haverstock DC, Coulter HO, Echols RM (1996) Results of a randomized trial comparing sequential intravenous/oral treatment with ciprofloxacin plus metronidazole to imipenem/cilastatin for intra-abdominal infections. Ann Surg 223:303–315
Acknowledgements
This work was financially supported by the University of Siena.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cerullo, G., Marrelli, D., Roviello, F. et al. Treatment of the intraabdominal abscesses through percutaneous ultrasound-guided drainage in oncological patients: Clinical and microbiological data. Surg Endosc 22, 1200–1205 (2008). https://doi.org/10.1007/s00464-007-9583-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-007-9583-3