Computed tomography-guided percutaneous abscess drainage in coloproctology: Review of the literature

Background: Percutaneous abscess drainage (PAD) of the lower abdomen and pelvis has been reported to reduce morbidity and mortality, shorten hospital stay and cut costs compared to a surgical approach. However, the wide differences in outcome reported by different authors indicate the need for an overview and further evaluations. This review evaluates each point of the procedure to explain the possible causes for such discrepancies in results. Methods: We performed a PubMed search of outcomes for percutaneous abscesses drainage, focusing on deep pelvic collections, which represent the most difficult task, searching among papers published from 1981 to 2006. Results: Ninety-nine papers were selected. Most authors emphasized that the most important steps of the care process are: (a) patient selection; (b) indications and contraindications; (c) choice of the best access route; (d) procedure performance; and (e) outcome (success and complication rates). Conclusions: PAD is a safe and effective alternative to surgery for draining deep infected fluid collections, with a higher success rate, lower complication rate and shorter hospital stay compared to surgical drainage. Meticulous technique and careful access planning seem to be the two most important factors affecting the outcome. © 2007 Springer-Verlag.