Percutaneous abscess drainage

Duodenal stump insufficiency is an infrequent but potentially devastating complication of upper gastrointestinal surgery. In the era of image-guided interventions, duodenal stump insufficiency is usually treated rather conservatively or with percutaneous interventions than with surgery. Herein, we present a case of a postsurgical duodenal stump fistula successfully treated in a step-by-step manner with percutaneous drainage of a periduodenal abscess-fistula complex, percutaneous transcholecystic biliary drainage for partial biliary diversion and percutaneous transcatheter fistula embolization via the duodenum with n-butyl-cyanoacrylate...

A 76-year-old woman, initially thought to have a simple abscess on her right upper eyelid, presented to our department of plastic and reconstructive surgery. Enhanced three-dimensional facial computed tomography (CT) revealed an abscess on the right upper lid, with a pyomucocele present in the right frontal sinus, accompanied by bone erosion in the superior wall of the right orbit. Based on the results of the CT scan, we diagnosed an atypical Pott's puffy tumor (PPT) with an abscess on the upper lid originating from the frontal sinusitis...

BACKGROUND: Early diagnosis of muscular tuberculosis (TB) without coexistent active skeletal involvement is often challenging because the disease is very rare and its clinical manifestation is nonspecific and misleading. To raise the awareness and emphasize early diagnosis of muscular TB, we present a case of multiple tuberculous muscle abscesses in a systemic lupus erythematosus (SLE) female, but without pulmonary tuberculosis (PTB), in order to increase awareness of and stress the need of early detection of muscular TB...

This is a current update on radiologic imaging and intervention of acute pancreatitis and its complications. In this review, we define the various complications of acute pancreatitis, discuss the imaging findings, as well as the timing of when these complications occur. The various classification and scoring systems of acute pancreatitis are summarized. Advantages and disadvantages of the 3 primary radiologic imaging modalities are compared. We then discuss radiologic interventions for acute pancreatitis. These include diagnostic aspiration as well as percutaneous catheter drainage of fluid collections, abscesses, pseudocysts, and necrosis...

Infective endocarditis is a potentially life-threatening condition caused by a bacterial infection of the heart valves. The incidence of splenic abscess associated with infective endocarditis varies between 1-10% of cases, and its presence may indicate a severe form of the disease. We present a 24-year-old man diagnosed with infective endocarditis who was found to have a splenic abscess upon further evaluation. The patient was initially managed conservatively with targeted antibiotics, but after unsuccessful percutaneous drainage, a splenectomy was performed...

A splenic abscess is rare after trauma, and it has been reported with high mortality rates. Treatment options include antibiotics, percutaneous pigtail drain, or surgical intervention; however, there are no specific guidelines for the treatment of splenic abscesses in trauma settings. We report a 69-year-old male who came in with a splenic abscess after angioembolisation for a splenic laceration after having a right hemicolectomy. Our case presents new information and current recommendations for the management of splenic abscesses based on a comprehensive literature review...

OBJECTIVES: In this narrative review, we aim to present two cases of transperineal drainage of prostate abscesses with a good clinical outcome. Furthermore, we reviewed the literature on this treatment approach and aim to propose a minimally invasive protocol for managing this rare condition. PATIENTS AND METHODS: Our patients are 33- and 61-year-old males who both underwent uncomplicated transperineal drainage of prostate abscess with the use of a Precision Point device with rapid clinical improvement and complete resolution of the abscess within the follow-up period...

"Penumbra sign" is a characteristic finding in magnetic resonance imaging (MRI) of Brodie's abscess, a rare variant of subacute osteomyelitis. We aimed to discuss the imaging finding penumbra sign that will help in the diagnosis of osteomyelitis and may be useful to clinicians in differential diagnosis. A 26-year-old male patient presented to the emergency department with complaints of pain and limping in the right knee that did not go away. He had a history of arthroscopic debridement and percutaneous fixation surgery due to osteochondral fragment 3 years ago...

INTRODUCTION AND IMPORTANCE: Pyogenic liver abscess (PLA) is a potentially life-threatening condition characterized by the formation of space-occupying lesions within the liver parenchyma. Despite advancements in diagnostic imaging and antibiotic therapies, complications such as biliary fistula formation can arise, posing challenges in management. CASE PRESENTATION: This case study presents a 23-year-old male patient with PLA complicated by a biliary fistula. Diagnostic imaging via CT scan and MRI confirmed a liver abscess and biliary dilation...

A 62-year-old male patient underwent pancreaticoduodenectomy with modified Child reconstruction for distal cholangiocarcinoma. After eight years, a contrast-enhanced computed tomography (CT) revealed a recurrent lesion at the biliojejunal anastomosis, and a biliary stent was placed for obstructive cholangitis in the right posterior segment of the liver. A right hepatectomy was planned for a local recurrent lesion;thus, percutaneous transhepatic portal embolization was performed on the portal vein's right branch to enlarge the left liver...

Abscesses associated with gallbladder perforation are often confined to the peri-gallbladder region. We herein report a rare case of gallbladder perforation in which the abscess cavity extended into the left upper quadrant. A 79-year-old woman developed gallbladder perforation secondary to acalculous cholecystitis. Computed tomography revealed fluid collection extending from the peri-gallbladder to the dorsal left hepatic lobe in contact with the stomach. We successfully treated percutaneous transhepatic gallbladder drainage and simultaneous endoscopic ultrasound-guided transgastric internal and external abscess drainage...

A man in his 50s with diabetes presented with backache, left flank pain and fever. On evaluation, he was found to have emphysematous pyelonephritis of the left kidney with a paranephric abscess extending into the posterior abdominal wall and superiorly up to the posterior chest wall and inferiorly extending up to the posterior superior iliac spine. The management involved the initiation of broad-spectrum antibiotics and percutaneous drainage of the abscess. However, as he continued to worsen symptoms-wise, he underwent computed-enhanced CT of the abdomen and thorax...

Splenic abscesses are rare pathologic conditions in which Actinomyces and Campylobacter species are rarely isolated. We present a 79-year-old female with multiple splenic abscesses from unknown sources with both Actinomyces species and Campylobacter rectus being isolated. She was initially treated conservatively with percutaneous drainage but eventually needed splenectomy. To our knowledge, this is the first documented case of Campylobacter rectus isolated from a splenic abscess.

Renal and perinephric abscesses are rare purulent infections within or around renal parenchyma, typically treated with antibiotics or various procedural approaches depending on abscess size. In this case report, we describe the novel use of a transgastric endoscopic ultrasound (EUS)-guided technique with placement of a stent for drainage between a renal abscess and the stomach in a patient who had failed attempted percutaneous drainage twice and where an open surgical approach was deemed inappropriate. The patient presented with a chief complaint of left flank pain, with CT revealing a ~4 x 4 cm renal abscess in the upper pole of the left kidney...

Liver abscesses caused by Klebsiella pneumoniae with a positive string test for hyperviscosity are more likely to develop invasive conditions than those with a negative string test. Here, we report the case of primary sclerosing cholangitis (PSC) who developed a treatment-resistant liver abscess caused by hyperviscous Klebsiella pneumoniae . A 67-year-old woman with PSC and a history of pancreaticoduodenectomy developed a fever. She had recurrent bacterial cholangitis after pancreaticoduodenectomy. This time, she was diagnosed with a liver abscess and bacterial cholangitis and then admitted to a local hospital...

Appendicoliths can drop into the peritoneal cavity during the course of an appendicectomy, or more commonly as a result of perforated appendicitis. We report the case of a patient with a history of recurrent retrohepatic abscesses over 7-year period due to a retained appendicolith and review the literature on perihepatic abscesses caused by retained appendicoliths. The abscess had been drained percutaneously 4 times without retrieval of the appendicolith and eventually the patient needed a laparotomy, drainage of the abscess, and extraction of the appendicolith...

The authors present minimally invasive surgical treatment of recurrent liver abscess caused by migration of fish bone from the upper gastrointestinal tract. Two-stage treatment implied small-caliber transparietal drainage of abscess with evacuation of purulent detritus at the first stage. At the second stage, primary percutaneous approach was transformed into access of sufficient diameter for flexible or rigid optics for visually controlled bone extraction. Foreign body removal through the drainage tube with endoscopic capture under visual control is preferable regarding safety compared to removal under ultrasound and/or X-ray control...

Page kidney (PK) is a rare renal condition characterized by external compression of the kidney, typically by a subcapsular hematoma, leading to resistant secondary hypertension due to hypoperfusion and ischemia. This hypertension is caused by the external compression of the kidney by a chronic subcapsular hematoma that activates the renin-angiotensin-aldosterone system (RAAS) system. Hematoma formation can result from external or internal trauma. The resolution of the hematoma can take months, and, in some cases, may necessitate a nephrectomy...

Splenic abscess is a rare condition that generally results from hematogenous spread and affects individuals with hemoglobinopathies or immunocompromising conditions. Although optimal management has recently been under contention, this condition was traditionally managed with splenectomy. We present a rare case of a 58-year-old male with chronic pancreatitis that developed a splenic abscess via a contiguous spread of a pancreatic pseudocyst. His condition was complicated by septic shock. The splenic abscess was managed with antibiotics, image-guided percutaneous drainage, and notably without surgical intervention...

BACKGROUND: The gold standard treatment for locally advanced colon cancer is curative surgery followed by adjuvant chemotherapy, although this approach is associated with serious concerns, such as high recurrence rates and occasionally unnecessary oversurgery. Neoadjuvant chemotherapy may be a promising strategy for overcoming these issues. This study reports a case of a recurrence-free patient who underwent curative resection without significant organ dysfunction after preoperative chemotherapy for locally advanced sigmoid colon cancer...