Expanded criteria for percutaneous abscess drainage
S. G. Gerzof, W. C. Johnson, A. H. Robbins and D. C. Nabseth
The original criteria for percutaneous abscess drainage were limited to
simple abscesses (well-defined, unilocular) with safe drainage routes. We
expanded these entry criteria to include complex abscesses (loculated,
ill-defined, or extensively dissecting abscesses), multiple abscesses,
abscesses with enteric fistulas or whose drainage routes traversed normal
organs, as well as complicated abscesses (appendiceal, splenic, interloop,
and pelvic). Using these expanded criteria, cure was achieved
nonoperatively in 92 (73.6%) of 125 abscesses with ten deaths (9%), and 11
complications (9%). Cure was achieved in 82% of simple abscesses, but only
45% of complex abscesses. There was no correlation between size, depth,
drainage route, or etiology of the abscess (spontaneous v postoperative)
with either cure or complications. We recommend a trial of percutaneous
drainage in all simple abscesses and most complex abscesses with clinical
response as the key determinant of the need for operative intervention.
