Browsing by Author "Mulu, Zeleke Mogne"

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    Cross Sectional Study of Pattern of Image Guided Percutaneous Abscess and Fluid Collections Aspiration and Drainage and Determinant of Successful Drainage at Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia from Hamle 2007ec - Meskerem 2013 Ec.
    (Addis Abeba University, 2020-09) Mulu, Zeleke Mogne; Dr.Kebede, Tesfaye( MD ,senior consultant radiologist ,SSBI, Associate professor of radiology)
    Introduction: Image guided percutaneous abscess and other fluid collection aspiration drainage (PCD) is safe and cost effective means of draining an abscess. PCD is noninvasive, has decreased procedure associated morbidly and mortality, reduced cost of treatment and reduces length of hospital stay as compared to open surgical drainage. The imaging modalities that can be used for drainage can either ultrasound or CT or both of the modalities. The technique of drainage can be done by one of either trocar or Seldinger technique based on the size of the abscess, depth from the skin surface and absence or presence of intervening structures. Objective: In this study assessment of pattern of image guided percutaneous fluid and abscess aspiration and drainage and determinant of success of the procedure were done. Methods: Cross sectional prospective and retrospective study was employed from September 2019 to September 2020GC. Cases of abscess collections were identified from the US and CT log books as well as the computerized data bases of i-care from Hamle 2007 to Meskerem 2020. The medical records of all patients with abscess or fluid collection, who had undergone PCD in the study period, were studied. Data was analyzed by using SPSS version 25.0 computer software. Then summarization and comparison of data was done. Binary logistic regression analysis was used to identify predictors of successful outcome following PCD. Results: 59 patients were included in this study .The mean age of patients who undergo PCD in this study is 43.58 with STD±15.6. Most of patients who undergo PCD were male accounting 67.8 %( 40 patients) and came from urban areas accounting 58.3%. The most common site of abscess in this study was liver accounting 45%. In 37.3% of patients Seldinger technique and 32.2% trocar techniques were used for catheter drainage of abscesses and fluid drainage. The mean amount of abscess drained is 281 ml±47 Std initially in the procedure room. The majority of abscesses drained had intermediate consistency 37.3% (22 abscesses drained).Microscopic examination was done only on 22 patients (37.3 %) of the samples of abscesses aspirated and drained. The most common microscopic finding that was confirmed was pyogenic from different sites. The mean time taken to fully drain an abscess collection or fluid collection was 5.714±6 Std days. The aspiration and drainage was successful in 55 patient accounting 93.2 %. The procedure had failed in four patients accounting 6.8%. Seven (11.9%) had major complications. Six developed recurrence and one had pneumothorax. The only negative predictors of successful outcome was having concomitant chronic illness (odds ratio [OR] = 0.006; 95% confidence interval [CI], 5.008-1.31; P = .001). Conclusions: The modality used to guide for abscess and fluid collection drainage is usually depends on the site, loculation and radiologist preference. Successful PCD can be done in almost every organs and spaces, with exception of intra-cranial collection, which are even multiloculated and have thick echo debris on pre-procedure ultrasound. The presence of chronic concomitant illness is one of the negative predictor of successful drainage. Mere aspiration in small and multiple collections is as successful as catheter drainage. PCD is proved to be safe and effective and has less morbidity and mortality, avoid general anesthesia and complications related to laparotomy, less numbers of days in the hospital and less cost compared to the surgical method of drainage.