Computed Tomography-guided Percutaneous Drainage in the Management of Intraperitoneal Abscess

Abstract

We carried out a retrospective analysis of 84 patients with intraperitoneal abscesses treated at Kaohsiung Medical University Hospital, Taiwan to assess our experience in their management. We compared outcomes between surgical drainage and computed tomography (CT)-guided percutaneous drainage. Each patient's characteristics, origin of abscess, clinical presentation, microbiology, Acute Physiology and Chronic Health Evaluation (APACHE) II score, treatment, and clinical outcomes were recorded. We compared patients' age, sex, complications, hospitalization days, morbidity, and mortality rate between those receiving surgical treatment and those receiving CT-guided percutaneous drainage. The most frequent symptoms and signs of these patients were leukocytosis, followed by fever and abdominal pain. There were significant differences in wound infection (p = 0.007), recurrent rate (p = 0.009), and enterocutaneous fistula (p = 0.032) between the two groups. In both groups, a higher APACHE II score was associated with both a higher morbidity and mortality (p < 0.001). Despite the higher recurrent rate, CT-guided percutaneous drainage was a safe and effective therapeutic alternative procedure to surgery when used as a definitive treatment. Surgical treatment is suggested in selected patients with either a complicated intraperitoneal abscess or failed CT-guided drainage.