Papanicolaou N, Mueller P R, Ferrucci J T, Dawson S L, Johnson R D, Simeone J F, Butch R J, Wittenberg J
AJR Am J Roentgenol. 1984 Oct;143(4):811-5. doi: 10.2214/ajr.143.4.811.
Thirty-five patients with postoperative enteric and/or biliary fistulae were diagnosed and treated by percutaneous catheter drainage. All were initially considered to have postoperative abdominal abscesses, and the enteric or biliary communications were unrecognized before radiologic intervention. In addition, at the time of initial catheter insertion, only six of the 35 abscesses were recognized as being associated with an underlying fistula. In the other 29 patients the fistulae were found either by clinical follow-up or contrast sinogram after 24-72 hr of catheter drainage. Percutaneous catheter drainage was the definitive treatment in 28 (80%) of the 35 patients. The seven failures were either from inadequate catheter positioning or inability to treat the primary cause of the fistula (e.g., radiation enteritis, perforated cancer). These data suggest that even abscesses with underlying fistulae, traditionally an indication for surgical intervention, may be successfully managed by percutaneous methods.
35例术后肠瘘和/或胆瘘患者经皮导管引流进行诊断和治疗。所有患者最初均被认为患有术后腹腔脓肿，在进行放射学干预之前，肠或胆的连通情况未被识别。此外，在最初插入导管时，35个脓肿中只有6个被识别为与潜在瘘管相关。在其他29例患者中，瘘管是在导管引流24 - 72小时后的临床随访或造影剂窦道造影中发现的。经皮导管引流是35例患者中28例（80%）的确定性治疗方法。7例治疗失败要么是因为导管定位不当，要么是无法治疗瘘管的主要病因（如放射性肠炎、穿孔性癌症）。这些数据表明，即使是伴有潜在瘘管的脓肿，传统上是手术干预的指征，也可以通过经皮方法成功处理。
