The role of CT-guided percutaneous drainage of loculated air collections: an institutional experience.

Published

Journal Article

OBJECTIVE: The purpose of this study is to describe our experience with the role of CT-guided percutaneous drainage of loculated intra-abdominal collections consisting entirely of gas. MATERIALS AND METHODS: An IRB-approved retrospective study analyzing patients with air-only intra-abdominal collections over an 8-year period was undertaken. Seven patients referred for percutaneous drainage were included. Size of collections, subsequent development of fluid, and microbiological yield were determined. Clinical outcome was also analyzed. RESULTS: Out of 2835 patients referred for percutaneous drainage between 2004 and 2012, seven patients (5M, 2F; average age 63, range 54-85) met criteria for inclusion with CT showing air-only collections. Percutaneous drain placement (five 8 Fr, one 10 Fr, and one 12 Fr) using Seldinger technique was performed. Four patients (57%) had recently undergone surgery (2 Whipple, 1 colectomy, 1 hepatic resection) while two (29%) had a remote surgery (1 abdominoperineal resection, 1 sigmoidectomy). Despite the lack of detectable fluid on the original CT, 6 patients (86%) had air and fluid aspirated at drainage, 5 (83%) of the aspirates developed positive microbacterial cultures. Four patients (57%) presented with fever at the time of the initial scan, all of whom had positive cultures from aspirated fluid. Four patients (57%) had leukocytosis, all of whom had positive cultures from aspirated fluid. CONCLUSIONS: Although relatively rare in occurrence, patients with air-only intra-abdominal collections with signs of infection should be considered for percutaneous management similar to that of conventional infected fluid collections. Although fluid is not visible on CT, these collections can produce fluid that contains organisms.

Full Text

Duke Authors

Cited Authors

  • Patel, BN; Morgan, M; Tyler, D; Paulson, E; Jaffe, TA

Published Date

  • October 2015

Published In

Volume / Issue

  • 40 / 8

Start / End Page

  • 3257 - 3264

PubMed ID

  • 26329977

Pubmed Central ID

  • 26329977

Electronic International Standard Serial Number (EISSN)

  • 1432-0509

Digital Object Identifier (DOI)

  • 10.1007/s00261-015-0537-2

Language

  • eng

Conference Location

  • United States