Usefulness of CT-Guided Percutaneous Catheter Drainage Using a Modified Version of the Seldinger Technique for the Treatment of Intra-abdominal Small Abscess and Poorly Depicted Fluid Collection on Sonogram

To evaluate the usefulness of CT-guided percutaneous catheter drainage (PCD) using a modified version of the Seldinger technique for deep-seated, small abscesses and poorly depicted fluid collection on abdominal sonogram. Fifty-nine cases of CT-guided PCD were performed on 56 patients. Four techniques were applied to secure safe access routes, which include scan postural change, angulation of the gantry, traversal of organs, and using a dissecting needle which can push the intervening bowel. Three landmarks (depth of the front and back wall of the fluid collection and the end point of catheter advancement over the guide wire) were indicated on the drainage catheter for extracorporeal direct observation of moving distance and location of the catheter during the insertion process. The technical success rate, clinical outcome, complications, and instrumental impairments were reviewed. The technical success rate was 100% (59/59), and no grave complications occurred. Four cases (7%) of crooked guide wire insertion were noted. The clinical outcome revealed a 95% (56/59) successful treatment rate and a 5% (3/59) failed treatment rate, which was caused by undissolved hematoma (1/59) and fistula (2/59). The results of this study suggest that CT-guided PCD using a modified version of the Seldinger technique for deep-seated, small abscesses and poorly depicted fluid collections on an abdominal sonogram is useful in terms of accuracy and safety