COMPUTED TOMOGRAPHY-GUIDED PERCUTANEOUS ABSCESS DRAINAGE IN INTESTINAL DISEASE - FACTORS ASSOCIATED WITH OUTCOME

PURPOSE: This study was designed to assess the efficacy of computed to mography-guided percutaneous abscess drainage in intestinal disease. M ETHODS. Retrospective chart review of patients who underwent percutane ous abscess drainage for complications of intestinal disease with or w ithout surgery between 1990 and 1994, RESULTS: Eighty-two patients wit h 111 abscesses were identified, Causes of abscess included anastomoti c leaks (35 percent), postoperative complications without leak (30 per cent), and diverticular disease (23 percent). Complete success (no sur gery necessary) was achieved in 53 of 82 patients (65 percent). Nine p atients (11 percent) who underwent interval surgery were classified as having partial successes. Twenty-six of 26 (100 percent) well-defined unilocular collections containing pus were successfully drained. Comp lex abscesses (loculated, poorly defined, multiple, associated with fi stula, draining feces) were successfully drained in 35 of 55 patients (63 percent). Success rates varied inversely with the number of compli cating factors present. Apache II scores of 15 or higher were associat ed with decreased success rates. CONCLUSION: Percutaneous abscess drai nage is a highly successful technique for treatment of patients with i ntraabdominal infection related to intestinal disease. Although severa l factors are associated with decreased success rates and multiple com plicating factors combine to reduce success rates, no identifiable fac tor or combination of factors preclude the possibility of a successful outcome, [Key words: Abscess; Computed tomography-guided drainage; Co mplications; Anastomotic leak].