Abdominal abscess drainage under radiologic guidance: causes of failure.

The results of percutaneous drainage of abdominal abscesses in 136 patients are analyzed, revealing a failure rate of 23% (31 patients). The mortality rate was 1.4% (two patients); the rate of serious complications was 5% (seven patients). Failure rate was lowest in critically ill patients having palliative drainage only (12%), emphasizing the importance of immediate drainage to stabilize such patients. The low mortality rate is also attributed to prompt palliative drainage. Technical errors were most commonly responsible for failure of procedures (14%), especially failure to recognize and respond to loculation or subseptation, premature withdrawal of drains (12 patients), and inappropriate approach to the abscess (nine patients). Assignment of patients to a clinical interventional radiology service for the duration of this treatment may greatly facilitate management.