Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Effectiveness of Fluoroscopic and US - Guided Percutaneous Catheter Drainage for Iliopsoas Abscess through the Anterolateral Transabdominal Approach

장요근 농양의 경피적 배액술에서 초음파와 투시조영 유도 하 전측면 경복부 접근법의 유용성

  • Choi, Ho-Cheol (Department of Radiology, Gyeongsang National University, College of Medicine) ;
  • Shin, Tae-Beom (Department of Radiology, Gyeongsang National University, College of Medicine) ;
  • Park, Mee-Jung (Department of Radiology, Gyeongsang National University, College of Medicine) ;
  • Kim, Ji-Eun (Department of Radiology, Gyeongsang National University, College of Medicine) ;
  • Choi, Hye-Young (Department of Radiology, Gyeongsang National University, College of Medicine) ;
  • Bae, Kyung-Soo (Department of Radiology, Gyeongsang National University, College of Medicine) ;
  • Choi, Dae-Seob (Department of Radiology, Gyeongsang National University, College of Medicine) ;
  • Na, Jae-Boem (Department of Radiology, Gyeongsang National University, College of Medicine) ;
  • Jeong, Seong-Hoon (Department of Radiology, Gyeongsang National University, College of Medicine)
  • 최호철 (경상대학교 의과대학 영상의학과교실) ;
  • 신태범 (경상대학교 의과대학 영상의학과교실) ;
  • 박미정 (경상대학교 의과대학 영상의학과교실) ;
  • 김지은 (경상대학교 의과대학 영상의학과교실) ;
  • 최혜영 (경상대학교 의과대학 영상의학과교실) ;
  • 배경수 (경상대학교 의과대학 영상의학과교실) ;
  • 최대섭 (경상대학교 의과대학 영상의학과교실) ;
  • 나재범 (경상대학교 의과대학 영상의학과교실) ;
  • 정성훈 (경상대학교 의과대학 영상의학과교실)
  • Published : 2011.02.01
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Abstract

Purpose: We evaluated the effectiveness of performing fluoroscopic and ultrasonography guided percutaneous catheter drainage (PCD) through the anterolateral transabdominal approach for treating iliopsoas abscess. Materials and Methods: From January 2008 to December 2009, fluoroscopic and US-guided PCD through the anterolateral transabdominal approach was performed on sixteen iliopsoas abscesses of fourteen patients (7 males and 7 females; mean age: 63 years; age range: 30-87 years). Six abscesses were on the right side and ten abscesses were on the left side. The location of the abscesses were the psoas muscle (n=7), the iliacus muscle (n=7) and the iliopsoas muscle (n=2). All the procedures were performed under fluoroscopy and US guidance in the angiography room. The clinical findings before and after the procedure, the duration of catheter insertion and the procedure-related complications were evaluated. Results: 15 out of the 16 iliopsoas abscesses were effectively treated. The duration of catheter insertion was 5- 27 days (mean: 14.6) days. No patient had significant complications during or after drainage. One patient died of uncontrolled diabetes complications and shock on the 9th day after percutaneous catheter drainage. One recurrence was noted 5 months after removal of the catheter. This patient underwent aspiration and antibiotic treatment for this lesion and the patient improved. Conclusion: Fluoroscopic and US-guided PCD for iliopsoas abscess through the anterolateral transabdominal approach is an effective and safe procedure.

목적: 장요근 농양 배액술에서 투시조영과 초음파 유도 하 전측면 경복부 접근법의 유용성에 대해 알아보고자 하였다. 대상과 방법: 2008년 1월부터 2009년 12월까지 초음파와 투시조영하에 전측면 경복부 접근법으로 장요근 농양에 대해 경피적 배액술을 시행 받은 14명의 환자를 대상으로 하였다(남 7, 여 7; 평균 63세 연령군 30-87세). 총16개의 장요근 농양으로 우측에 6개, 좌측에 10개의 농양이 있었다. 2명에서 양측에 농양이 있었다. 요근에 위치한 경우가 7예, 장근에 7예, 그리고, 장요근에 걸쳐 위치한 경우가 2예 있었다. 시술은 투시 촬영이 가능한 혈관 조영실에서 초음파와 투시 조영하에 시행되었다. 임상 경과, 카테터의 유지 기간, 재발 여부, 그리고 합병증에 대해 알아보았다. 결과: 16개 장요근 중 15개에서 효과적으로 치료되었다. 카테터 유지 기간은 평균 14.6일(5-27일)이었고, 시술과 관련된 합병증은 배액술 중이나 배액술 후에도 발생하지 않았다. 1명의 환자에서 당뇨 합병증과 쇼크로 인해 시술 후 9일째 사망하였다. 다른 1명의 환자에서는 시술 후 도관 제거한 뒤 5개월째 동일한 부위에 재발하였고, 세침 흡입과 항생제 치료로 호전되었다. 결론: 장요근 농양 배액술에서 투시조영과 초음파 유도 하 전측면 경복부 접근법은 안전하고, 효과적인 방법으로 생각된다.

Keywords

References

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