CardioVascular and Interventional Radiology

, Volume 28, Issue 6, pp 744–750 | Cite as

Percutaneous Drainage of 300 Intraperitoneal Abscesses with Long-Term Follow-Up

  • Devrim Akinci
  • Okan AkhanEmail author
  • Mustafa N. Ozmen
  • Nevzat Karabulut
  • Orhan Ozkan
  • Barbaros E. Cil
  • Musturay Karcaaltıncaba


The purpose of the study was to evaluate the efficacy of percutaneous drainage of intraperitoneal abscesses with attention to recurrence and failure rates. A retrospective analysis of percutaneous treatment of 300 intraperitoneal abscesses in 255 patients (147 male, 108 female; average age: 38 years; range: 40 days to 90 years) for whom at least 1-year follow-up data were available was performed. Abscesses were drained with fluoroscopic, sonographic, or computed tomographic guidance. Nine abscesses were drained by simple aspiration; catheter drainage either by Seldinger or trocar technique was used in the remaining 291 abscesses with 6F to 14 F catheters. Initial cure and failure rates were 68% (203/300) and 12% (36/300), respectively. Sixty-one abscesses (20%) were either palliated or temporized. The recurrence rate was 4% (12/300) and nine of them were cured by recatheterization, whereas three of them were treated by medication or surgery. The overall success and failure rates were 91% (273/300) and 9% (27/300), respectively, with temporized, palliated, and recatheterized recurred abscesses. The 30-day mortality rate was 3.1% (8/255). The mean duration of catheterization was 13 days. Intraperitoneal abscesses with safe access routes should be drained percutaneously because of high success and low morbidity, mortality, and recurrence rates.


Abscess Percutaneous drainage Intraperitoneal 


  1. 1.
    Altemeier WA, Culbertsen WR, Fullen WD, Shook CD (1973) Intraabdominal abscesses. Am J Surg 125:70–79CrossRefPubMedGoogle Scholar
  2. 2.
    Fry DE, Garrison RN, Heitsch RC, et al. (1980) Determinants of death in patients with intraabdominal abscesses. Surgery 88:517–523PubMedGoogle Scholar
  3. 3.
    Gazelle GS, Mueller PR (1994) Abdominal abscesses. Imaging and intervention. Radiol Clin North Am 32:913–932Google Scholar
  4. 4.
    Hinsdale JG, Jaffe BM (1984) Re-operation for intraabdominal sepsis. Ann Surg 199:31–36PubMedGoogle Scholar
  5. 5.
    Sheafor DH, Paulson EK, Simmons CM, et al. (1998) Abdominal percutaneous interventional procedures: Comparison of CT and US guidance. Radiology 207:705–710PubMedGoogle Scholar
  6. 6.
    Heneghan JP, Everts RJ, Nelson RC (1999) Multiple fluid collections: CT- or US-guided aaspiration—Evaluation of microbiologic results and implications for clinical practice. Radiology 212:669–672PubMedGoogle Scholar
  7. 7.
    Lambiase RE, Deyoe L, Cronan JJ, et al. (1992) Percutaneous drainage of 335 consecutive abscesses: results of primary drainage with1-year follow-up. Radiology 184:167–179PubMedGoogle Scholar
  8. 8.
    Lang EK, Springer RM, Glorioso LW, et al. (1986) Abdominal abscess drainage under radiologic guidance: causes of failure. Radiology 159:329–336PubMedGoogle Scholar
  9. 9.
    Schechter S, Eisentat TE, Oliver GC, et al. (1994) Computerized scan-guided drainage of intra-abdominal abscesses. Preoperative and postoperative modalities in colon and rectal surgery. Dis Colon Rectum 37:984–988Google Scholar
  10. 10.
    Lambiase RE (1991) Percutaneous abscess and fluid drainage: A critical review. Cardiovasc Intervent Radiol 14:143–157PubMedGoogle Scholar
  11. 11.
    Hemming A, Davis NL, Robins RE (1991) Surgical versus percutaneous drainage of intra-abdominal abscesses. Am J Surg 161:593–595CrossRefPubMedGoogle Scholar
  12. 12.
    Olak J, Christou NV, Stein LA, et al. (1986) Operative vs percutaneous drainage of intra-abdominal abscesses. Arch Surg 121:141–146PubMedGoogle Scholar
  13. 13.
    van Sonnenberg E, Mueller PR, Ferrucci JT (1984) Percutaneous drainage of 250 abdominal abscesses and fluid collections. I. Results, failures, and complications. Radiology 151:337–341Google Scholar
  14. 14.
    Giorgio A, Tarantino L, Mariniello N, et al. (1995) Pyogenic liver abscesses: 13 years of experience in percutaneous needle aspiration with US guidance. Radiology 195:122–124PubMedGoogle Scholar
  15. 15.
    Casola G, van Sonnenberg E, Neff CC, et al. (1987) Abscesses in Crohn’s disease: Percutaneous drainage. Radiology 163:19–22PubMedGoogle Scholar
  16. 16.
    vanSonnenberg E, Wing VW, Casola G, et al. (1984) Temporizing effect of percutaneous drainage of complicated abscesses in critically ill patients. Am J Roentgenol 142:821–826PubMedGoogle Scholar
  17. 17.
    Betsch A, Wiskirchen J, Trübenbach J, et al. (2002) CT-guided percutaneous drainage of intra-abdominal abscesses: APACHE III score stratification of 1-year results. Eur Radiol 12:2883–2889PubMedGoogle Scholar
  18. 18.
    Aassar OS, LaBerge JM, Gordon RL, et al. (1999) Percutaneous management of abscess and fistula following pancreaticoduodenectomy. Cardiovasc Intervent Radiol 22:25–28CrossRefPubMedGoogle Scholar
  19. 19.
    Froelich JJ, El-Sheik M, Wagner HJ, et al. (2000). Feasibility of C-arm-supported CT fluoroscopy in percutaneous abscess drainage procedures. Cardiovasc Intervent Radiol 23:423–430CrossRefPubMedGoogle Scholar
  20. 20.
    Rajak CL, Gupta S, Jain S, et al. (1998) Percutaneous treatment of liver abscesses: Needle aspiration versus catheter drainage. Am J Roentgenol 170:1035–1039PubMedGoogle Scholar
  21. 21.
    vanSonnenberg E, Muller PR, Schiffman HR, et al. (1985) Intrahepatic amebic abscesses: Indications for and results of percutaneous catheter drainage. Radiology 156:631–635PubMedGoogle Scholar
  22. 22.
    Ralls PW, Barnes PF, Johnson MB, et al. (1987) Medical treatment of hepatic amebic abscesses: rare need for percutaneous catheter drainage. Radiology 165:805–807PubMedGoogle Scholar
  23. 23.
    Ramani A, Ramani R, Kumar MS, et al. (1993) Ultrasound-guided needle aspiration of amoebic liver abscess. Postgrad Med J 69:381–383PubMedGoogle Scholar
  24. 24.
    Akgun Y, Tacyildiz İH, Celik Y (1999) Amebic liver abscess: Changing trends over 20 years. World J Surg 23:102–106CrossRefPubMedGoogle Scholar
  25. 25.
    Miller JM, Ahola DT, Bretzman PA, et al. (1997) Percutaneous management of hepatic abscess: a perspective by interventional radiologists. J Vasc Intervent Radiol 8:241–247Google Scholar
  26. 26.
    Dondelinger RF, Kurdziel JC, Gathy C (1990) Percutaneous treatment of pyogenic liver abscess: a critical analysis of results. Cardiovasc Intervent Radiol 13:174–82PubMedGoogle Scholar
  27. 27.
    Gerzof SG, Johnson WC, Robbins AH, et al. (1985) Intrahepatic pyogenic abscesses: Treatment by percutaneous drainage. Am J Surg 149:487–494PubMedGoogle Scholar
  28. 28.
    Attar B, Levendoglu H, Cuasay NS (1986) CT-guided percutaneous aspiration and catheter drainage of pyogenic liver abscesses. Am J Gastroenterol 8:550–555Google Scholar
  29. 29.
    Lerner RM, Spataro RF (1984) Splenic abscesses: percutaneous drainage. Radiology 153:643–645PubMedGoogle Scholar
  30. 30.
    Quinn SF, vanSonnenberg E, Casola G, et al. (1986) Interventional radiology in the spleen. Radiology 169:289–291Google Scholar
  31. 31.
    McNicholas MMJ, Mueller PR, Lee MJ, et al. (1995) Percutneous drainage of subphrenic fluid collections that occur after splenectomy: efficacy and safety of transpleural versus extrapleural approach. Am J Roentgenol 165:355–359PubMedGoogle Scholar
  32. 32.
    Mueller PR, Simeone JF, Butch RJ, et al. (1986) Percutaneous drainage of subphrenic abscesses: A review of 62 patients. Am J Roentgenol 147:1237–1240PubMedGoogle Scholar
  33. 33.
    Jeffrey RB, Tolentino CS, Federle MP, et al. (1987) Percutaneous drainage of periappendiceal abscesses: Review of 20 patients. Am J Roentgenol 149:59–62PubMedGoogle Scholar
  34. 34.
    vanSonnenberg E, Wittich GR, Casola G, et al. (1987) Periappendiceal abscesses: Percutaneous drainage. Radiology 163:23–26PubMedGoogle Scholar
  35. 35.
    Peer A, Strauss S (1991) Percutaneous drainage of postappendectomy abscesses complicated by enteric communication. Cardiovasc Intervent Radiol 14:106–108PubMedGoogle Scholar
  36. 36.
    Neff CC, vanSonnenberg E, Casola G, et al. (1987) Diverticular abscesses: Percutaneous drainge. Radiology 163:15–18PubMedGoogle Scholar
  37. 37.
    Stabile B, Puccio E, vanSonnenberg E, et al. (1990) Preoperative percutaneous drainage of diverticular abscesses. Am J Surg 159:99–104Google Scholar
  38. 38.
    Lambiase RE, Cronan JJ, Dorfman GS, et al. (1988) Percutaneous drainage of abscesses in patients with Crohn disease. Am J Roentgenol 150:1043–1045Google Scholar
  39. 39.
    Gerzof SG, Robbins AH, Johnson WC, et al. (1981) Percutaneous catheter drainage of abdominal abscesses: A five year experience. N Engl J Med 305:653–657PubMedGoogle Scholar
  40. 40.
    Lambiase RE, Cronan JJ, Dorfman GS, et al. (1989) Postoperative abscesses with enteric communication: Percutaneous treatment. Radiology 171:497–500PubMedGoogle Scholar
  41. 41.
    Papanicolaou N, Mueller PR, Ferrucci JT, et al. (1984) Abscess fistula association: Radiologic recognition and percutaneous management. Am J Roentgenol 143:811–815PubMedGoogle Scholar
  42. 42.
    Schuster MR, Crummy AB, Wojtowycz MM, et al. (1992) Abdominal abscesses associated with enteric fistulas: percutaneous management. J Vasc Intervent Radiol 3:359–363Google Scholar
  43. 43.
    Do H, Lambiase RE, Deyoe L, et al. (1991) Percutaneous drainage of hepatic abscesses: Comparison of results in abscesses with and without intrahepatic biliary communication. Am J Roentgenol 157:1209–1212PubMedGoogle Scholar
  44. 44.
    Gervais DA, Ho CH, O’Neill, et al. (2004) Recurrent abdominal and pelvic abscesses: Incidence, results of repeated percutaneous drainage, and underlying causes in 956 drainages. Am J Roentgenol 182:463–466PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • Devrim Akinci
    • 1
  • Okan Akhan
    • 1
    Email author
  • Mustafa N. Ozmen
    • 1
  • Nevzat Karabulut
    • 2
  • Orhan Ozkan
    • 1
  • Barbaros E. Cil
    • 1
  • Musturay Karcaaltıncaba
    • 1
  1. 1.Department of RadiologyHacettepe Medical SchoolSihhiyeTurkey
  2. 2.Pamukkale University Medical SchoolTurkey

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