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An Adjunct to Surgical Therapy

Sanjay Saini, MD; Peter R. Mueller, MD; Jack Wittenberg, MD; Rodney J. Butch, MD; Grant V. Rodkey, MD; Claude E. Welch, MD

Arch Surg. 1986;121(4):475-478.

Abstract
• We undertook this study to determine whether a computed tomography—guided, percutaneous preoperative drainage of a peridiverticular abscess can safely allow a one-stage procedure in patients requiring surgery for acute diverticulitis. In 17 patients evaluated prospectively by computed tomography, thin-needle aspiration demonstrated purulent fluid collection in 11 patients. Percutaneous catheter drainage was undertaken in eight patients. In the three remaining patients, the abscess was either too small to warrant drainage or no safe access route was present. Seven of eight patients had a single-stage resection within one to three weeks of percutaneous catheter drainage. There were no complications. Our studies suggest that a combined radiological-surgical approach has the potential to reduce morbidity and hospital costs without increasing mortality in the management of perforated colon diverticulitis with associated abscess formation.

(Arch Surg 1986;121:475-478)

Author Affiliations
From the Departments of Radiology (Drs Saini, Mueller, Wittenberg, and Butch) and Surgery (Drs Rodkey and Welch), Massachusetts General Hospital, Boston.

Footnotes
Accepted for publication Jan 5, 1986.

Read before the 66th Annual Meeting of the New England Surgical Society, Dixville Notch, NH, Oct 12, 1985.

Reprint requests to Department of Radiology, Massachusetts General Hospital, Boston, MA 02114 (Dr Saini).

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