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Published in: Abdominal Radiology 4/2019

01-04-2019 | Interventional Radiology

Percutaneous drainage and management of fluid collections associated with necrotic or cystic tumors in the abdomen and pelvis

Authors: David H. Ballard, Mahati Mokkarala, Horacio B. D’Agostino

Published in: Abdominal Radiology | Issue 4/2019

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Abstract

Purpose

The purpose of the study was to evaluate the efficacy and safety of percutaneous drainage for palliation of symptoms and sepsis in patients with cystic or necrotic tumors in the abdomen and pelvis.

Materials and methods

This is a single center retrospective study of 36 patients (18 men, mean age = 51.1 years) who underwent percutaneous drainage for management of cystic or necrotic tumors in the non-postoperative setting over an 11-year period. Nineteen patients with intraabdominal fluid collections associated with primary malignancies included: cervical (n = 7), colorectal (n = 3), urothelial (n = 3), and others (n = 6). The 17 patients with fluid collections associated with intraabdominal metastases stemmed from the following primary malignancies: oropharyngeal squamous cell carcinoma (n = 3), colorectal (n = 3), ovarian (n = 2), lung (n = 2), melanoma (n = 2) along with others (n = 5). Indications for percutaneous drainage were as follows: pain (36/36; 100%); fever and/or leukocytosis (34/36; 94%), and mass effect (21/36; 58%). Seven patients underwent additional sclerosis with absolute alcohol. Criteria for drainage success were temporary or definitive relief of symptoms and sepsis control.

Results

Successful sepsis control was achieved in all patients with sepsis (34/34; 100%) and 30/36 (83%) patients had improvement in pain. Duration of catheterization ranged from 2 to 90 days (mean = 22 days). There were four cases of fluid re-accumulation and one patient developed catheter tract seeding. Alcohol ablation was successful in two patients (2/7; 29%). Nearly all patients (34/36; 94%) died during the follow-up period.

Conclusions

Percutaneous drainage was effective for palliative treatment of symptomatic cystic and necrotic tumors in the majority of patients in this series.
Literature
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Metadata
Title
Percutaneous drainage and management of fluid collections associated with necrotic or cystic tumors in the abdomen and pelvis
Authors
David H. Ballard
Mahati Mokkarala
Horacio B. D’Agostino
Publication date
01-04-2019
Publisher
Springer US
Published in
Abdominal Radiology / Issue 4/2019
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-018-1854-z

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