Percutaneous image-guided aspiration versus catheter drainage of abdominal and pelvic collections

Purpose: Intra abdominal and pelvic fluid collection is a serious problem that requires drainage. The goal of our study was to report our experience and evaluate the feasibility, safety and outcome of percutaneous image-guided aspiration versus catheter drainage of abdominal and pelvic collections.Patients and methods: This is a retrospective study of 84 patients (45 males and 39 females of mean age 45.1 + 16.9 years) who have intra abdominal or pelvic collections and have a good coagulation profile. Small ( < 5 cm) collections were treated by aspiration. Continuous catheter drainage was applied to failed aspirations or large collection.Results: 112 Drainage procedures were carried out in 84 patients guided by either ultrasound or CT. Aspirations of 31 collections were carried out in 22 patients, and 81 catheters (8-10 French) were inserted in 66 patients. Four patients had both aspirations and catheters. The collections were either sterile or pus. Median diameter of aspirated collections was 4.2 cm (3-5 cm) compared to 7.2 cm (6-12 cm) of those treated by catheters P < 0.05. Technical success was 100% in both aspiration and catheter insertion using the Seldinger technique but it was 87% with the trocar technique. Clinical success rate for aspiration was 94% (n=29) but increased to 100% after catheter insertion and that of catheter was 95%. No major complications were encountered.Conclusion: Image-guided drainage of abdominal and pelvic collections is safe and effective and can avoid surgery in selected patients. Aspiration should be tried before catheter insertion. Careful catheter selection for trochar technique is important. (C) 2013 Production and hosting by Elsevier B.V.