Percutaneous ultrasound-guided drainage of intra-abdominal abscesses.

A retrospective review of 200 patients with intra-abdominal abscesses treated by percutaneous ultrasound-guided drainage is reported. Abscesses were simple in 151 patients (75.5 per cent) and complex in 49 (24.5 per cent). In 12 patients the abscess communicated with the gastrointestinal tract. There were 17 critically ill patients for whom percutaneous drainage was the only therapeutic option possible. The success rate was 94.7 per cent (143 of 151 patients) for simple abscess and 69 per cent (34 of 49) for complex abscess. The overall success rate was 88.5 per cent. The mortality rate was 1.3 per cent (two patients) for simple and 16 per cent (eight patients) for complex abscess. The overall mortality rate was 5.0 per cent. Percutaneous ultrasound-guided drainage should be the initial drainage procedure in patients with a simple abdominal abscess. The presence of a complex abscess should not prevent an attempt at percutaneous catheter drainage, particularly in high-risk patients, although the risk of failure is greater in such cases.