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  Vol. 121 No. 2, February 1986 TABLE OF CONTENTS
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  PAPERS READ BEFORE THE FIFTH ANNUAL MEETING OF THE SURGICAL INFECTION SOCIETY, NEW ORLEANS, APRIL 29 TO APRIL 30, 1985-PART II
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Operative vs Percutaneous Drainage of Intra-abdominal Abscesses

Comparison of Morbidity and Mortality

Jemi Olak, MD; Nicholas V. Christou, MD; Laurence A. Stein, MD; Giovanna Casola, MD; Jonathan L. Meakins, MD

Arch Surg. 1986;121(2):141-146.


Abstract

• This retrospective case-controlled study compares the morbidity and mortality of 27 percutaneously drained (PD) abscesses with 27 that were surgically drained (SD). Patients were matched for age, sex, diagnosis, and abscess etiology and location. There was no difference in severity of illness (acute physiology score [APS] = 8.3 vs 10.2), comparable morbidity (29.6% vs 40.7%), or mortality (11.0% vs 7.4%) between PD and SD groups. Duration of drainage was significantly longer in the PD group; however, this is explained in part by the 48% vs 18.5% difference in associated fistulae. Failures of the SD group had a higher mean APS (15) than both failures of the PD group (APS=9.3) and successes of the SD group (APS = 8.6). All three PD group deaths and half of the SD group deaths were related to ongoing sepsis. Surgical drainage of intra-abdominal abscess is as successful as PD. Percutaneous drainage is reasonable initial treatment for intra-abdominal abscess; however, early assessment of clinical status and frequent reassessment are mandatory to ensure that failures are dealt with early. We present a drainage algorithm.

(Arch Surg 1986;121:141-146)



Author Affiliations

From the Departments of Surgery (Drs Olak, Christou, and Meakins) and Radiology (Dr Stein), Royal Victoria Hospital, Montreal, and the Department of Radiology, Montreal General Hospital (Dr Casola) and McGill University, Montreal (Drs Olak, Christou, Stein, Casola, and Meakins).


Footnotes

Accepted for publication Oct 10, 1985.

Read before the Fifth Annual Meeting of the Surgical Infection Society, New Orleans, April 30, 1985.

Reprint requests to S10.30, Royal Victoria Hospital, 687 Pine Ave W, Montreal, Quebec, Canada H3A 1A1 (Dr Meakins).



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