Chen S L, Huang H L, Liaw Y J
Department of Urology, Tainan Municipal Hospital.
Zhonghua Yi Xue Za Zhi (Taipei). 1992 Aug;50(2):172-5.
Retroperitoneal abscess have been a difficult diagnostic and therapeutic challenge in the past. With the advent of precise, noninvasive imaging modalities, they now are defined more easily. Percutaneous guided catheter drainage has changed our traditional therapeutic approach to this disease, in the majority of cases. In general, massive semilytic fatty tissue of retroperitoneal abscess can not pass through the ordinary percutaneous catheter. Herein we report 2 cases of retroperitoneal abscess successfully treated with percutaneous guided thick catheter drainage combined with medical control. Percutaneous guided thick catheter drainage can be performed in most uroradiological facilities. There are many advantages to percutaneous ultrasound-guided thick catheter drainage compared with surgical drainage of retroperitoneal abscess. They include: earlier diagnosis and treatment, avoidance of general anaesthesia, operations which involve risks and complications, shorter and less expensive therapy, easier nursing care, better infection control with the closed drainage system, and greater patient acceptance. Therefore, we believe that a trial of thick catheter percutaneous drainage of retroperitoneal abscess, without a complex septum, should be the initial mode of therapy, and surgical intervention should be undertaken only when percutaneous drainage fails or is contraindicated.
过去，腹膜后脓肿一直是诊断和治疗上的难题。随着精确、无创成像方式的出现，现在对其的定义更容易了。在大多数情况下，经皮引导下的导管引流改变了我们对这种疾病的传统治疗方法。一般来说，腹膜后脓肿大量的半溶解脂肪组织无法通过普通的经皮导管。在此，我们报告2例经皮引导下粗导管引流联合药物治疗成功治愈的腹膜后脓肿病例。经皮引导下粗导管引流在大多数泌尿系统放射科都可以进行。与腹膜后脓肿的手术引流相比，经皮超声引导下粗导管引流有许多优点。这些优点包括：更早的诊断和治疗、避免全身麻醉、避免涉及风险和并发症的手术、更短且费用更低的治疗、更容易的护理、通过封闭引流系统更好地控制感染以及患者更高的接受度。因此，我们认为对于没有复杂分隔的腹膜后脓肿，粗导管经皮引流试验应作为初始治疗方式，只有在经皮引流失败或有禁忌证时才应进行手术干预。
