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Computerized tomographic scan-guided drainage of intra-abdominal abscesses

Preoperative and postoperative modalities in colon and rectal surgery

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Computerized tomographic (CT) scan-guided percutaneous drainage of intra-abdominal abscesses has changed the colon and rectal surgeon's approach to preoperative and postoperative intra-abdominal infections. This study is an effort to prove the efficacy of CT scan-guided percutaneous drainage. METHODS: A retrospective study was performed on 133 patients who underwent CT scan drainage of intra-abdominal abscesses over a 6.3-year period. RESULTS: 67 patients had underlying lower gastrointestinal disease. Twenty-three of these patients (34 percent) had spontaneous abscesses and underwent drainage as a preoperative or final modality, whereas 44 patients (66 percent) were drained postoperatively. In 78 percent of patients, surgery was successfully avoided or delayed. Ten patients had acute diverticulitis associated with a large pelvic abscess. Eight patients underwent successful CT scanguided percutaneous drainage, yielding an 80 percent success rate. Morbidity from the CT scan-guided percutaneous drainage procedure in spontaneous and postoperative groups was 0 percent and 9 percent, respectively. Mortality was 9 percent and 11 percent, respectively, and associated with an elevated Acute Physiology and Chronic Health Evaluation II (APACHE II) score. CONCLUSION: CT scan-guided percutaneous drainage of intra-abdominal abscesses is an important adjunct to colon and rectal surgery because roughly 80 percent of spontaneous and postoperative abscesses were successfully managed.

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Authors and Affiliations

  1. Division of Colon & Rectal Surgery, UMDNJ, Plainfield, New Jersey

    Theodore E. Eisenstat M.D., Gregory C. Oliver M.D., Robert J. Rubin M.D. & Eugene P. Salvati M.D.

  2. Department of Surgery, The Miriam Hospital/Brown University, Providence, Rhode Island

    Steven Schechter M.D.

Authors
  1. Steven Schechter M.D.
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  2. Theodore E. Eisenstat M.D.
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  3. Gregory C. Oliver M.D.
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  4. Robert J. Rubin M.D.
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  5. Eugene P. Salvati M.D.
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Schechter, S., Eisenstat, T.E., Oliver, G.C. et al. Computerized tomographic scan-guided drainage of intra-abdominal abscesses. Dis Colon Rectum 37, 984–988 (1994). https://doi.org/10.1007/BF02049309

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