A prospective study of outcome of double pigtail catheter drainage in the management of breast abscess: analysis of outcome
Keywords:Breast abscess, Double pigtail, Catheter
Background: Breast abscesses, localized collection of pus in the breast, are most common in young lactating women. Traditional treatment of breast abscesses is by surgical incision, digital disruption of septa, evacuation of contents with occasional placement of surgical drains, and administration of systemic antibiotics. Percutaneous large-bore needle aspiration with or without ultrasound guidance is generally employed as the first line treatment of breast abscesses. It is generally done for medium to large sized unilateral abscesses and requires repeated aspirations for complete resolution of the abscess cavity.
Methods: We have conducted this prospective study at SMIMER Hospital, Surat, Gujarat, India from January 2020 to January 2021. After ethical approval a group of 25 patients with unilateral breast abscesses irrespective of the lactational status were treated by percutaneous double catheter drains inserted under ultrasound guidance under the effect of local anaesthesia and evaluated for 3 months.
Results: The resultant cosmetic effect was good, with no reported recurrence on 3 month follow-up.
Conclusions: Double pigtail catheter drainage in appropriately selected cases of beast abscess has superior outcome in compare to published result of other technique for drainage of beast abscess specially in minimal scarring, early resolution of abscess cavity and decreases in the total duration of treatment.
Falco G, Foroni M, Castagnetti F. Ultrasound-guided percutaneous catheter drainage of large breast abscesses in lactating women: how to preserve breastfeeding safely. Breastfeed Med. 2016;11:555-6.
Christensen AF, Vejborg I, Severinsen N, Nielsen M B. Ultrasound-guided drainage of breast abscesses: Results in 151 patients. Br J Radiol. 2005;78:185-8.
Wiseman Sam M, Lam Elaine, Chan Tiffany. Breast abscess: evidence based management recommendations. Expert Rev Anti Infect Ther. 2014;12(7):753-62.
Berna-Serna Juan D, Madrigal M. Percutaneous management of breast abscesses. an experience of 39 cases. Ultrasound in Med and Biol. 2004;30(1):1-6.
Garg P, Rathee SK, Lal A. Ultrasonically guided percutaneous drainage of breast abscess. J Indian Med Assoc. 1997;95(11):584-5.
Arora S, Odiya S, Mathur R. Comparative study of conventional incision and drainage versus percutaneous placement of suction drain: changing trend of breast management. Int Surg J. 2016;3(3):1580-4.
Dudley FAH. Acute infections. In: Hamilton Bailey’s emergency surgery. United States of America: Bristol; 1986:104.
Rains HJA, Ritchie DH. The breast. In: Bailey and Love’s Short practice of Surgery. London: Lewis; 1981:660.
Rintoul FR. Operations on the breast. In: Farquharson’s textbook of operative surgery. United States of America: Chirchill Livingstone; 1986:279.
Shruti KS, Porwal R, Singh A, Soni A, Sagar P. A comparative study of outcomes in management of breast abscess by ultrasound guided needle aspiration and incision and drainage. Int J Contemp Surg. 2020;8:1.
Kandi AJ, Gite VA, Varudkar AS. A comparative study of outcomes inmanagement of breast abscess by ultrasound guided needle aspiration against incision and drainage. MedPulse Int Med J. 2014;1(10):655-9.
Parakh AM, Diwakar MK. Assessment of open versus closed modalities of breast abscess treatments: a cross sectional comparative study. Int Surg J. 2018;5:2142-7.