TY - JOUR
T1 - Abscess-Fistula Complexes
T2 - A Systematic Approach for Percutaneous Catheter Management
AU - Ballard, David H.
AU - Hamidian Jahromi, Alireza
AU - Li, Anna Y.
AU - Vea, Romulo
AU - Ahuja, Chaitanya
AU - D'Agostino, Horacio B.
N1 - Publisher Copyright:
© 2015 SIR.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Purpose To describe a systematic catheter management approach for treatment of abscesses with enteric fistulae by abscess evacuation and selective fistula tract cannulation in a series of patients with postprocedural abscess-fistula complexes. Materials and Methods This single-center retrospective study included 27 patients (17 male; mean age, 51.3 y) who underwent percutaneous drainage of postprocedural abscess-fistula complexes from January 2005 to September 2013. There were 15 low-output and 12 high-output fistulae. Intra-abdominal abscesses were evacuated by percutaneous drainage. Multiple catheters were used for collections with viscous fluid or size ≥ 6 cm in diameter. High-output fistulae and recurrent low-output fistulae had additional catheter cannulation of the enteric hole to facilitate the creation of a controlled enterocutaneous tract. There was no preexisting cutaneous tract before catheter insertion in 23 fistulae. Results Abscess-fistula complex resolution occurred in 24 patients (88.9%). Of the 3 cases of failure, 2 patients required surgical repair of the fistula, and 1 patient died. Mean number of drainage procedures was 7.0, and mean catheter duration was 76.1 days. There was no significant difference in catheter duration of low-output and high-output abscess-fistula complexes (P =.34); however, high-output patients underwent significantly more procedures (9.1 vs 6.1, P =.025). There were 15 fistulae that were cannulated (11 high-output and 4 low-output fistulae). Cannulated abscess-fistula complexes had significantly longer catheter duration (102.5 d vs 53.2 d, P =.04) and underwent significantly more procedures (8.4 vs 5.4, P =.04). Conclusions The catheter management strategy was successful in resolving most abscess-fistula complexes in this series.
AB - Purpose To describe a systematic catheter management approach for treatment of abscesses with enteric fistulae by abscess evacuation and selective fistula tract cannulation in a series of patients with postprocedural abscess-fistula complexes. Materials and Methods This single-center retrospective study included 27 patients (17 male; mean age, 51.3 y) who underwent percutaneous drainage of postprocedural abscess-fistula complexes from January 2005 to September 2013. There were 15 low-output and 12 high-output fistulae. Intra-abdominal abscesses were evacuated by percutaneous drainage. Multiple catheters were used for collections with viscous fluid or size ≥ 6 cm in diameter. High-output fistulae and recurrent low-output fistulae had additional catheter cannulation of the enteric hole to facilitate the creation of a controlled enterocutaneous tract. There was no preexisting cutaneous tract before catheter insertion in 23 fistulae. Results Abscess-fistula complex resolution occurred in 24 patients (88.9%). Of the 3 cases of failure, 2 patients required surgical repair of the fistula, and 1 patient died. Mean number of drainage procedures was 7.0, and mean catheter duration was 76.1 days. There was no significant difference in catheter duration of low-output and high-output abscess-fistula complexes (P =.34); however, high-output patients underwent significantly more procedures (9.1 vs 6.1, P =.025). There were 15 fistulae that were cannulated (11 high-output and 4 low-output fistulae). Cannulated abscess-fistula complexes had significantly longer catheter duration (102.5 d vs 53.2 d, P =.04) and underwent significantly more procedures (8.4 vs 5.4, P =.04). Conclusions The catheter management strategy was successful in resolving most abscess-fistula complexes in this series.
UR - http://www.scopus.com/inward/record.url?scp=84940050960&partnerID=8YFLogxK
U2 - 10.1016/j.jvir.2015.06.030
DO - 10.1016/j.jvir.2015.06.030
M3 - Article
C2 - 26314645
AN - SCOPUS:84940050960
SN - 1051-0443
VL - 26
SP - 1363
EP - 1367
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 9
M1 - 3504
ER -