Utility of ultrasound in the hands of the surgeon in percutaneous drainage of abdominal and pelvic abscess

Abstract

Background: abscesses or symptomatic abdominal collections have multifactorial origin, although in more than 65% of the cases, the etiology is postoperative.
Objective: to describe the applicability and utility of abdominal and pelvic percutaneous drainage guided by ultrasound in a surgical team.
Methods: a series of consecutive patients with ultrasound guided percutaneous drainage of abdominal or pelvic collection performed during in a 9 year period.
Results: from June 2003 to June 2012, 87 procedures were performed, 79 of them guided with ultrasound.The etiology was postoperative in 51 patients (64.5%). Thirty eight (48.1 %) were female. Average age was 55 (range 18-92). Drainage was performed under ultrasound and radiology guide in 78 patients (98.7%) and by laparoscopic and ultrasound guide in one patient. Fifteen patients (18.9%) presented morbidity related to the procedure: fever in 7 patients, unusual pain in 3 (all with intercostal drainage), chills and sweating in 3, cellulitis in one, and a colonic leak in one. All patients were included into of Dindo-Clavien Classification of Surgical Complications and the results were: Grade I: 14 patients, Grade IIIb: one patient. There was no mortality related to the procedure; seven patients (8.8%) died because of other causes. The overall success rate was 88.6 % (70 cases), and satisfactory in 94% (74 cases).
Conclusions: in surgeons hands, ultrasound guided percutaneous drainage of abdominal and pelvic collections was a feasible, effective and safe procedure with low morbidity.