Portal de Periódicos da CAPES

EUS-guided drainage of subphrenic abscess

2004; Elsevier BV; Volume: 59; Issue: 4 Linguagem: Inglês

10.1016/s0016-5107(03)02878-5

1097-6779

Stefan Seewald, Boris Brand, Salem Omar, Ichiro Yasuda, Uwe Seitz, Gerardo Mendoza, Tim Holzmann, Stefan Groth, Frank Thonke, N. Soehendra,

Otolaryngology and Infectious Diseases

Surgery currently is the mainstay treatment for subphrenic abscesses, although operative mortality is high. 1. Spain D.A. Martin R.C. Carrillo E.H. Polk Jr., H.C. Twelfth rib resection. Preferred therapy for subphrenic abscess in selected surgical patients. Arch Surg. 1997; 132: 1203-1206 Crossref PubMed Scopus (17) Google Scholar , 2. Bufalari A. Giustozzi G. Moggi L. Postoperative intraabdominal abscesses: percutaneous versus surgical treatment. Acta Chir Belg. 1996; 96: 197-200 PubMed Google Scholar , 3. Dadvani S.A. Shkrob O.S. Lotov A.N. Musaev G. Karpova R.V. Diagnosis and treatment of isolated subdiaphragmatic liquid accumulations under ultrasound control. Khirurgiia (Mosk). 1999; ([Russian]): 13-18 PubMed Google Scholar , 4. Serrano A. Dahl E.P. Rubin R.H. Ferrucci Jr., J.T. Mueller P.R. Malt R.A. Eclectic drainage of subphrenic abscesses. Arch Surg. 1984; 119: 942-945 Crossref PubMed Scopus (7) Google Scholar Percutaneous drainage is another treatment option, but it also is associated with significant morbidity. 2. Bufalari A. Giustozzi G. Moggi L. Postoperative intraabdominal abscesses: percutaneous versus surgical treatment. Acta Chir Belg. 1996; 96: 197-200 PubMed Google Scholar , 5. Mueller P.R. Simeone J.F. Butch R.J. Saini S. Stafford S.A. Vici L.G. et al. Percutaneous drainage of subphrenic abscess: a review of 62 patients. AJR Am J Roentgenol. 1986; 147: 1237-1240 Crossref PubMed Scopus (42) Google Scholar , 6. van Gansbeke D. Matos C. Gelin M. Muller P. Zalcman M. Deviere J. et al. Percutaneous drainage of subphrenic abscesses. Br J Radiol. 1989; 62: 127-133 Crossref PubMed Scopus (11) Google Scholar Complications of percutaneous drainage usually relate to the route used for catheter placement, which is in close proximity to the pleura and lung. Hemothorax and inadvertent placement of the catheter into the pleural cavity are the most common complications associated with drainage. EUS-guided drainage potentially is a safe and effective therapeutic strategy for drainage of subphrenic abscess, because EUS provides excellent anatomic and vascular orientation, as the diaphragm, the celiac trunk, and the splenic and paragastric vessels are being readily identified (Fig. 1). Two cases are reported in which subphrenic abscesses were successfully and safely drained under EUS guidance.