Percutaneous management of inadvertently inserted catheter into inferior vena cava during liver abscess drainage.

摘要

Percutaneous drainage coupled with parenteral antibiotic therapy is a well-accepted and effective primary treatment for liver abscess [1, 2]. This minimally invasive approach has a high clinical success rate and a low complication rate, and it avoids general anesthesia and its attendant risks [3]. Such surgery is generally reserved for concurrent surgical disease, abscess rupture, or failed percutaneous treatment [4, 5]. Rajak et al. compared the efficacy of needle aspiration versus catheter drainage in their study of 50 patients and concluded that percutaneous catheter drainage is more effective than needle aspiration in the treatment of liver abscesses, and needle aspiration, if limited to two attempts, has a high failure rate [6]. Various complications of percutaneous catheter drainage of liver abscesses have been described, such as secondary bacterial infection with an indwelling catheter, contamination of subphrenic, perihe-patic, and pleural spaces, rupture of abscess, perforation of adjacent abdominal organs, pneumothorax, hemorrhage, and hepatobronchial fistula.