vanSonnenberg E, Wittich G R, Casola G, Cabrera O A, Gosink B B, Resnick D L
AJR Am J Roentgenol. 1987 Oct;149(4):769-72. doi: 10.2214/ajr.149.4.769.
Sonographic characteristics and percutaneous catheter drainage of thigh abscesses in 18 patients are described. Most of these patients had underlying diseases including osteomyelitis, trauma, diabetes mellitus, rheumatoid arthritis, leukemia, lymphoma, sepsis, bleeding dyscrasia, and autoimmune disease. Previous procedures on these thigh collections included seven operations and 12 nondiagnostic ward aspirations. All collections were shown by sonography to be either anterior or anterolateral. Two cases referred for drainage were posteromedial; sonography showed these to be mycotic pseudoaneurysms. The abscesses were either anechoic or hypoechoic, and occasionally had debris and septations. Abscesses associated with underlying osteomyelitis abutted the femur; those related to other causes generally were more superficial within muscle or fascial layers. Sonographically guided catheter drainage successfully cured all patients, even those in whom ward aspiration or formal surgery had been unsuccessful. Sonography is a simple and inexpensive method of imaging and guiding the drainage of thigh abscesses. Percutaneous catheter drainage is the treatment of choice in cases in which simple emergency room or ward incision and drainage are inadequate.
本文描述了18例大腿脓肿的超声特征及经皮导管引流情况。这些患者大多患有基础疾病，包括骨髓炎、创伤、糖尿病、类风湿关节炎、白血病、淋巴瘤、败血症、出血性疾病及自身免疫性疾病。此前对这些大腿脓肿的处理包括7次手术及12次在病房进行的诊断性穿刺抽吸。超声检查显示所有脓肿均位于大腿前部或前外侧。有2例因引流而转诊的脓肿位于后内侧；超声检查显示为霉菌性假性动脉瘤。脓肿表现为无回声或低回声，偶尔有碎屑和分隔。与潜在骨髓炎相关的脓肿紧邻股骨；与其他病因相关的脓肿通常在肌肉或筋膜层内更表浅。超声引导下的导管引流成功治愈了所有患者，即使是那些在病房穿刺抽吸或正规手术治疗失败的患者。超声检查是一种简单且经济的大腿脓肿成像及引流引导方法。对于单纯急诊室或病房切开引流不足的病例，经皮导管引流是首选治疗方法。
