Cross Sectional Study Of Pattern Of Image Guided Percutaneous Abscess And Fluid Collections Aspiration And Drainage And Determinant Of Successful Drainage At Tikur Anbessa Specialized Hospital Addis Ababa University Addis Ab

Introduction: Image guided percutaneous abscess and other fluid collection aspirationrndrainage (PCD) is safe and cost effective means of draining an abscess. PCD isrnnoninvasive, has decreased procedure associated morbidly and mortality, reduced costrnof treatment and reduces length of hospital stay as compared to open surgical drainage.rnThe imaging modalities that can be used for drainage can either ultrasound or CT orrnboth of the modalities. The technique of drainage can be done by one of either trocar orrnSeldinger technique based on the size of the abscess, depth from the skin surface andrnabsence or presence of intervening structures. rnObjective: In this study assessment of pattern of image guided percutaneous fluid andrnabscess aspiration and drainage and determinant of success of the procedure wererndone. rnMethods: Cross sectional prospective and retrospective study was employed fromrnSeptember 2019 to September 2020GC. Cases of abscess collections were identifiedrnfrom the US and CT log books as well as the computerized data bases of i-care fromrnHamle 2007 to Meskerem 2020. The medical records of all patients with abscess orrnfluid collection, who had undergone PCD in the study period, were studied. Data wasrnanalyzed by using SPSS version 25.0 computer software. Then summarization andrncomparison of data was done. Binary logistic regression analysis was used to identifyrnpredictors of successful outcome following PCD. rnResults: 59 patients were included in this study .The mean age of patients whornundergo PCD in this study is 43.58 with STD±15.6. Most of patients who undergo PCDrnwere male accounting 67.8 %( 40 patients) and came from urban areas accountingrn58.3%. The most common site of abscess in this study was liver accounting 45%. Inrn37.3% of patients Seldinger technique and 32.2% trocar techniques were used forrncatheter drainage of abscesses and fluid drainage. The mean amount of abscessrndrained is 281 ml±47 Std initially in the procedure room. The majority of abscessesrndrained had intermediate consistency 37.3% (22 abscesses drained).Microscopicrnexamination was done only on 22 patients (37.3 %) of the samples of abscessesrnaspirated and drained. The most common microscopic finding that was confirmed wasrnpyogenic from different sites. The mean time taken to fully drain an abscess collectionrnor fluid collection was 5.714±6 Std days. The aspiration and drainage was successful inrn55 patient accounting 93.2 %. The procedure had failed in four patients accountingrn6.8%. Seven (11.9%) had major complications. Six developed recurrence and one hadrnpneumothorax. The only negative predictors of successful outcome was havingrnconcomitant chronic illness (odds ratio [OR] = 0.006; 95% confidence interval [CI], 5.008-1.31;rnPrn=rn.001).rnConclusions: The modality used to guide for abscess and fluid collection drainage isrnusually depends on the site, loculation and radiologist preference. Successful PCD canrnbe done in almost every organs and spaces, with exception of intra-cranial collection,rnwhich are even multiloculated and have thick echo debris on pre-procedure ultrasound.rnThe presence of chronic concomitant illness is one of the negative predictor ofrnsuccessful drainage. Mere aspiration in small and multiple collections is as successfulrnas catheter drainage. PCD is proved to be safe and effective and has less morbidity andrnmortality, avoid general anesthesia and complications related to laparotomy, lessrnnumbers of days in the hospital and less cost compared to the surgical method ofrndrainage.

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