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Title: A New CT-Guided Modified Trocar Technique for Drainage of Difficult Locations Abscesses

Abstract

PurposeComputed tomography (CT) is commonly used to guide drainage of deep-seated abdominal fluid collections. However, in some cases, these collections seem to be inaccessible due to surrounding organs or their being in difficult locations. The aim of this study is to describe a modified Trocar technique to drain collections in difficult locations, especially those in the subphrenic space, without passing through intervening organs.Materials and MethodsThis retrospective case series study describes seven inpatients who underwent CT-guided drainage using a modified Trocar technique for abscesses that are difficult to access percutaneously. All patients provided written informed consent prior to the procedure. After placement of a 12–14F catheter inside the peritoneum, the Trocar stylet was removed so that the tip of the catheter became blunt and flexible to avoid injury to organs and structures in the catheter route, and the catheter was slowly advanced towards the collection using CT guidance and tactile sensation. After reaching the target, the stylet was reintroduced to enter the abscess wall.ResultsAll procedures were performed using an anterior abdominal wall access with adequate catheter positioning and resulted in clinical status improvement in the days after the drainage. No complications related to the procedure were identified in any of themore » patients.ConclusionsThe modified Trocar technique for percutaneous CT-guided drainage of abdominal abscesses may be feasible for lesions that are difficult to access with conventional methods.« less

Authors:
; ; ; ; ; ;  [1]; ;  [2];  [1]
  1. AC Camargo Cancer Center, Department of Imaging (Brazil)
  2. AC Camargo Cancer Center, Department of Abdominal Surgery (Brazil)
Publication Date:
OSTI Identifier:
22645212
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 5; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABSCESSES; COMPUTERIZED TOMOGRAPHY; FLUIDS; INJURIES; ORGANS; PATIENTS; PERITONEUM; POSITIONING; VASCULAR DISEASES

Citation Formats

Tyng, Chiang J., E-mail: chiangjengtyng@gmail.com, Amoedo, Maurício K., Bohrer, Yves, Bitencourt, Almir G. V., Barbosa, Paula N. V., Almeida, Maria Fernanda A., Zurstrassen, Charles E., Coimbra, Felipe J. F., Costa, Wilson L. da, and Chojniak, Rubens. A New CT-Guided Modified Trocar Technique for Drainage of Difficult Locations Abscesses. United States: N. p., 2017. Web. doi:10.1007/S00270-017-1577-5.
Tyng, Chiang J., E-mail: chiangjengtyng@gmail.com, Amoedo, Maurício K., Bohrer, Yves, Bitencourt, Almir G. V., Barbosa, Paula N. V., Almeida, Maria Fernanda A., Zurstrassen, Charles E., Coimbra, Felipe J. F., Costa, Wilson L. da, & Chojniak, Rubens. A New CT-Guided Modified Trocar Technique for Drainage of Difficult Locations Abscesses. United States. doi:10.1007/S00270-017-1577-5.
Tyng, Chiang J., E-mail: chiangjengtyng@gmail.com, Amoedo, Maurício K., Bohrer, Yves, Bitencourt, Almir G. V., Barbosa, Paula N. V., Almeida, Maria Fernanda A., Zurstrassen, Charles E., Coimbra, Felipe J. F., Costa, Wilson L. da, and Chojniak, Rubens. Mon . "A New CT-Guided Modified Trocar Technique for Drainage of Difficult Locations Abscesses". United States. doi:10.1007/S00270-017-1577-5.
@article{osti_22645212,
title = {A New CT-Guided Modified Trocar Technique for Drainage of Difficult Locations Abscesses},
author = {Tyng, Chiang J., E-mail: chiangjengtyng@gmail.com and Amoedo, Maurício K. and Bohrer, Yves and Bitencourt, Almir G. V. and Barbosa, Paula N. V. and Almeida, Maria Fernanda A. and Zurstrassen, Charles E. and Coimbra, Felipe J. F. and Costa, Wilson L. da and Chojniak, Rubens},
abstractNote = {PurposeComputed tomography (CT) is commonly used to guide drainage of deep-seated abdominal fluid collections. However, in some cases, these collections seem to be inaccessible due to surrounding organs or their being in difficult locations. The aim of this study is to describe a modified Trocar technique to drain collections in difficult locations, especially those in the subphrenic space, without passing through intervening organs.Materials and MethodsThis retrospective case series study describes seven inpatients who underwent CT-guided drainage using a modified Trocar technique for abscesses that are difficult to access percutaneously. All patients provided written informed consent prior to the procedure. After placement of a 12–14F catheter inside the peritoneum, the Trocar stylet was removed so that the tip of the catheter became blunt and flexible to avoid injury to organs and structures in the catheter route, and the catheter was slowly advanced towards the collection using CT guidance and tactile sensation. After reaching the target, the stylet was reintroduced to enter the abscess wall.ResultsAll procedures were performed using an anterior abdominal wall access with adequate catheter positioning and resulted in clinical status improvement in the days after the drainage. No complications related to the procedure were identified in any of the patients.ConclusionsThe modified Trocar technique for percutaneous CT-guided drainage of abdominal abscesses may be feasible for lesions that are difficult to access with conventional methods.},
doi = {10.1007/S00270-017-1577-5},
journal = {Cardiovascular and Interventional Radiology},
number = 5,
volume = 40,
place = {United States},
year = {Mon May 15 00:00:00 EDT 2017},
month = {Mon May 15 00:00:00 EDT 2017}
}