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September 1988

Improved Treatment of Intra-abdominal AbscessA Result of Improved Localization, Drainage, and Patient Care, Not Technique

Author Affiliations

From the Departments of Surgery, Oregon Health Sciences University, Portland (Drs CW Deveney and KE Deveney), Portland Veterans Administration Medical Center (Drs CW Deveney and KE Deveney), and Sinai Hospital of Detroit (Dr Luric).

Arch Surg. 1988;123(9):1126-1130. doi:10.1001/archsurg.1988.01400330106016

• Outcome in patients with abdominal abscesses treated at the University of Pennsylvania, Philadelphia, between 1973 and 1978 (group 1) was compared with that in patients treated between 1981 and 1986 (group 2). Mortality was less in group 2 patients (21% vs 39% in group 1). The decrease in mortality in group 2 was accompanied by a greater percentage of successful predrainage localization (74% vs 55% in group 1), successful initial drainage (76% vs 55% in group 1), and decreased predrainage organ failure (23% vs 52% in group 1). Because failure of initial drainage and predrainage organ failure were associated with increased mortality, improvement in both of these criteria contributed substantially to the lower mortality in group 2 patients. There were no differences in mortality, in initial success in drainage, or in length of hospital stay when 29 group 2 patients who underwent percutaneous drainage were compared with 37 patients who underwent surgical drainage. Mortality (22% vs 21%) and initial success (78% vs 72%) were similar for patients who underwent surgical and percutaneous drainage, respectively. We conclude that initial success in localization and drainage of the abscess is more important than whether drainage is surgical or percutaneous.

(Arch Surg 1988;123:1126-1130)