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Recurrent Abdominal and Pelvic Abscesses: Incidence, Results of Repeated Percutaneous Drainage, and Underlying Causes in 956 Drainages

¹ All authors: Department of Radiology, Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit St., White 270, Boston, MA 02114.

OBJECTIVE. We undertook this study to determine the incidence and results of repeated (secondary) percutaneous abscess drainage performed on recurrent abscesses after successful initial (primary) percutaneous abscess drainage.

MATERIALS AND METHODS. Imaging studies from patients who underwent multiple drainages were reviewed to define a cohort of patients who underwent secondary percutaneous abscess drainage after successful initial percutaneous abscess drainage of the same abscess. Medical records of these patients were then reviewed to assess the results of secondary percutaneous abscess drainage.

RESULTS. Forty-five abscesses in 43 patients required secondary percutaneous abscess drainage. Twenty-four of the 43 patients avoided surgery. Secondary percutaneous abscess drainage was successful in evacuating the abscess cavity in 39 (91%) of 43 patients. Duration of drainage and time until recurrence were not significant predictors for avoiding surgery. Mean duration of secondary percutaneous abscess drainage was significantly longer than mean duration of primary percutaneous abscess drainage, but duration of secondary percutaneous abscess drainage (25 vs 14 days, respectively; p = 0.007) did not differ significantly between patients who ultimately required surgery and those who did not (17 vs 11 days, respectively; p = 0.10). Time to recurrence ranged from 2 days to 1 year (mean, 51 days).

CONCLUSION. After successful primary percutaneous abscess drainage, secondary percutaneous abscess drainage of recurrent abscesses succeeded in evacuating the abscess cavity in most patients, and surgery was avoided by slightly more than half. Patients with postoperative abscesses were significantly more likely to avoid surgery (p = 0.008), whereas patients with pancreatic abscesses were significantly more likely to require it (p = 0.03).

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