阑尾周围脓肿的经皮引流 经皮膈下脓肿引流 经皮盆腔脓肿和积液的引流肝脓肿引流 经皮腹腔脓肿引流
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经皮肝脓肿引流

时间:2018-05-11 08:36来源:未知 作者:Mr.Editor 点击:
Do we always need a drainage catheter ? 男性,憩室炎,多发性肝脓肿 Multiple drainage catheters Multiple large bore punctures Need for multiple fluoro controls Patients discomfort (5 catheters) Multiple punctures and aspiration Thick pus ca
Do we always need a drainage catheter ?

男性,憩室炎,多发性肝脓肿

   
Multiple drainage catheters
 
• Multiple large bore punctures
• Need for multiple fluoro controls
• Patient’s discomfort (5 catheters)

Multiple punctures and aspiration
 
• Thick pus cannot be aspirated
• May persist if communicating with bile ducts
• Must be converted to PAD if unsuccessful

超声引导下,套管针吸,广谱抗生素 Cefotetan 4g,Metronidazole 2g/day

12天后
  两个病灶第二次穿刺

完全缓解
   


• Abscesses near the dome are challenging Frequently necessary to transgress pleura
• Trial of antibiotics can be successful.
• Consider US/Fluoro or CT + Gantry angulation
• Occasionally require multiple catheters.
• Bacteremia during/following procedure relatively common-pre-procedure antibiotics
• Communication with bile ducts -usually settles if no biliary obstruction-catheter usually stays in longer

Filice C, Pirole F, Foglieni CS Gastroenterology 1990; 98:1366


   
   


多发肝脓肿

多发肝脓肿

   


   


   


比较
术前 术后4个月


肝脓肿与胆道相同

   

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