Over the past 20 years, percutaneous abscess drainage (PAD) has evolved from revolutionary to routine, replacing open surgical abscess drainage in all but the most difficult or inaccessible cases. It was originally believed that only patients with simple fluid collections were candidates for PAD. However, researchers have convincingly demonstrated that both septated and viscous fluid collections may be successfully treated percutaneously, particularly with the adjunctive use of lytic agents. The simpler the abscess, the more likely PAD will be rapidly successful. An aggressive practical approach with relatively simple devices and techniques may yield a high success rate with few complications.
CT- and ultrasound-guided catheters are used to locate and drain pus sacs in patients, most of whom have failed to improve with conventional chest-tube drainage due to a poorly positioned tube. Patients are treated successfully, averting surgery or further drainage or infections. Compared to the tubes used to drain abdominal abscesses, these catheters need less irrigation, and the catheter can be withdrawn in one step.