Percutaneous drainage of 250 abdominal abscesses and fluid collections. Part II: Current procedural concepts.

The initial skepticism concerning the capability of radiologically placed catheters to drain intraabdominal abscesses has been overcome by wide acceptance of the technique by general surgeons. In this review, we describe current procedural concepts based on our experience with percutaneous catheter drainage of 250 intraabdominal abscesses and fluid collections in 212 patients. We consider the mechanisms of successful percutaneous drainage and suggest differences between radiologic and surgical decompression. We describe the inconsistent correlations between image patterns and results of the diagnostic needle aspiration, especially in predicting the drainability of cavity contents. We review principles of catheter selection and aspects of postprocedure catheter management, including irrigation and timing of withdrawal.