Journal of vascular and interventional radiology : JVIR · 2015
Abscess-Fistula Complexes: A Systematic Approach for Percutaneous Catheter Management.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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История · было → стало
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Ballard David H, Hamidian Jahromi Alireza, Li Anna Y, Vea Romulo, Ahuja Chaitanya, D'Agostino Horacio B
Аннотация
PURPOSE: To describe a systematic catheter management approach for treatment of abscesses with enteric fistulae by abscess evacuation and selective fistula tract cannulation in a series of patients with postprocedural abscess-fistula complexes.
MATERIALS AND METHODS: This single-center retrospective study included 27 patients (17 male; mean age, 51.3 y) who underwent percutaneous drainage of postprocedural abscess-fistula complexes from January 2005 to September 2013. There were 15 low-output and 12 high-output fistulae. Intra-abdominal abscesses were evacuated by percutaneous drainage. Multiple catheters were used for collections with viscous fluid or size ≥ 6 cm in diameter. High-output fistulae and recurrent low-output fistulae had additional catheter cannulation of the enteric hole to facilitate the creation of a controlled enterocutaneous tract. There was no preexisting cutaneous tract before catheter insertion in 23 fistulae.
RESULTS: Abscess-fistula complex resolution occurred in 24 patients (88.9%). Of the 3 cases of failure, 2 patients required surgical repair of the fistula, and 1 patient died. Mean number of drainage procedures was 7.0, and mean catheter duration was 76.1 days. There was no significant difference in catheter duration of low-output and high-output abscess-fistula complexes (P = .34); however, high-output patients underwent significantly more procedures (9.1 vs 6.1, P = .025). There were 15 fistulae that were cannulated (11 high-output and 4 low-output fistulae). Cannulated abscess-fistula complexes had significantly longer catheter duration (102.5 d vs 53.2 d, P = .04) and underwent significantly more procedures (8.4 vs 5.4, P = .04).
CONCLUSIONS: The catheter management strategy was successful in resolving most abscess-fistula complexes in this series.
MATERIALS AND METHODS: This single-center retrospective study included 27 patients (17 male; mean age, 51.3 y) who underwent percutaneous drainage of postprocedural abscess-fistula complexes from January 2005 to September 2013. There were 15 low-output and 12 high-output fistulae. Intra-abdominal abscesses were evacuated by percutaneous drainage. Multiple catheters were used for collections with viscous fluid or size ≥ 6 cm in diameter. High-output fistulae and recurrent low-output fistulae had additional catheter cannulation of the enteric hole to facilitate the creation of a controlled enterocutaneous tract. There was no preexisting cutaneous tract before catheter insertion in 23 fistulae.
RESULTS: Abscess-fistula complex resolution occurred in 24 patients (88.9%). Of the 3 cases of failure, 2 patients required surgical repair of the fistula, and 1 patient died. Mean number of drainage procedures was 7.0, and mean catheter duration was 76.1 days. There was no significant difference in catheter duration of low-output and high-output abscess-fistula complexes (P = .34); however, high-output patients underwent significantly more procedures (9.1 vs 6.1, P = .025). There were 15 fistulae that were cannulated (11 high-output and 4 low-output fistulae). Cannulated abscess-fistula complexes had significantly longer catheter duration (102.5 d vs 53.2 d, P = .04) and underwent significantly more procedures (8.4 vs 5.4, P = .04).
CONCLUSIONS: The catheter management strategy was successful in resolving most abscess-fistula complexes in this series.