The percutaneous drainage of perisigmoid diverticular abscesses.

Study aim: The aim of this multicentric retrospective study was to report t he results on the percutaneous drainage of perisigmoid abscesses during acu te sigmoid diverticulitis in 12 patients. Patients and method: Between January 1993 and March 2000, 12 patients with a perisigmoid diverticular abscess were treated by antibiotic therapy and p ercutaneous drainage of the abscess. The patient population consisted of ei ght males and four females (mean age: 50.2 years). The diagnosis was establ ished in two out of seven cases by enema, in four cases out of seven by abd ominal ultrasonography, and in eight cases out of 11 by CT scan. Percutaneo us drainage was carried out in all cases, and was guided by ultrasonography (n = 3) and CT scan (n = 9). The mean duration of drainage was 6.5 days. Results: No drainage-associated complications were observed. Drainage combi ned with antibiotic treatment provided satisfactory results in ten out of 1 2 cases. Two cases of failure of the method occurred, and the patients invo lved were operated on day 4 and week 5 by colectomy with protective lateral ileostomy. There was an early recurrence of the abscess in three patients, who were treated by the Hartmann procedure in one case, and by one-stage c olectomy in two cases. Five patients underwent a secondary one-stage colect omy. Two patients in whom no residual abscess was detected were not operate d on at the time of the study. Conclusion: Percutaneous drainage of perisigmoid diverticular abscesses com bined with antibiotic therapy provided efficient treatment in ten out of 12 cases. Secondary one-stage colectomy was performed in seven out of the eig ht patients requiring further surgery. (C) 2001 Editions scientifiques et m edicales Elsevier SAS.