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April 1986

Percutaneous Drainage of Diverticular AbscessAn Adjunct to Surgical Therapy

Author Affiliations

From the Departments of Radiology (Drs Saini, Mueller, Wittenberg, and Butch) and Surgery (Drs Rodkey and Welch), Massachusetts General Hospital, Boston.

Arch Surg. 1986;121(4):475-478. doi:10.1001/archsurg.1986.01400040113018

• We undertook this study to determine whether a computed tomography—guided, percutaneous preoperative drainage of a peridiverticular abscess can safely allow a one-stage procedure in patients requiring surgery for acute diverticulitis. In 17 patients evaluated prospectively by computed tomography, thin-needle aspiration demonstrated purulent fluid collection in 11 patients. Percutaneous catheter drainage was undertaken in eight patients. In the three remaining patients, the abscess was either too small to warrant drainage or no safe access route was present. Seven of eight patients had a single-stage resection within one to three weeks of percutaneous catheter drainage. There were no complications. Our studies suggest that a combined radiological-surgical approach has the potential to reduce morbidity and hospital costs without increasing mortality in the management of perforated colon diverticulitis with associated abscess formation.

(Arch Surg 1986;121:475-478)

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