Postoperative abscesses with enteric communication: percutaneous treatment.

Overview

Patients with abscesses that have enteric communication in the absence of underlying inflammatory bowel disease require modification of the usual percutaneous treatment techniques. An ongoing source of output (gastrointestinal secretions) is a complicating factor in treatment. The results of percutaneous treatment of 17 abscesses with enteric communication in 16 patients without a history of inflammatory bowel disease were reviewed. The long-term cure rate was 71%. Pancreatic involvement in abscess-bowel communication diminished the cure rate to 50% (two of four) and lengthened the duration of drainage required. The results suggest that percutaneous treatment of abscesses with enteric communication is a viable alternative to surgical intervention. Minimal morbidity and no mortality were directly attributable to percutaneous therapy in this series. When the pancreas is involved in the establishment or persistence of the abscess-bowel communication, or when the underlying bowel is diseased, the rate of success decreases.