Inadvertent percutaneous catheter gastroenterostomy during abscess drainage: significance and management

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Abstract
Eleven cases of inadvertent catheter insertion into the small bowel or stomach during percutaneous abdominal abscess drainage are reviewed. Recognition of the intraluminal catheter position was made by contrast-enhanced fluoroscopy in all patients 1-6 days after catheter insertion. No evidence of leakage of intestinal contents into the peritoneal cavity was noted either clinically or radiologically. All cases occurred after drainage of a centrally located midabdominal collection, but the ultimate outcome was not compromised. In nine of 11 cases, catheter drainage alone was sufficient; two cases required additional surgical drainage. Considerations for management include a prolonged period of catheter drainage to allow evolution of a fibrous tract and gradual catheter withdrawal. These data confirm the growing experience with purposeful percutaneous gastrostomy that percutaneous catheterization of the gastrointestinal tract can occur without major sequelae.