Lesser sac abscesses and fluid collections: drainage by transhepatic approach.

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Abstract
A basic tenet of surgical and percutaneous drainage of abdominal abscesses is to avoid transgression of 1 anatomic area in order to drain another. Indeed, the most critical determinant of successful radiologic catheter drainage is the location of the collection and the availability of a safe access route. Twelve abscesses and fluid collections in the lesser peritoneal sac were drained percutaneously using an access route across the intervening liver. This rather unusual access was chosen when other approaches were contraindicated because of surrounding the colon, stomach or spleen. All collections were drained successfully, and no specific complications such as hemorrhage, bile leak or liver abscess occurred. Placement of an abscess drainage catheter should be done through the peripheral portion of the liver if possible. The technique offer a new, safe approach to percutaneous drainage of hitherto inaccessible collections.