ENDOSCOPIC ULTRASOUND-GUIDED DRAINAGE OF PELVIC ABSCESS WITH LUMEN-APPOSING STENT

Aims Endoscopic ultrasonography (EUS) is a well-established technique for transenteric drainage of abdominal collections that can replace surgical or percutaneus approach. In the same way, lumen-apposing stents have changed these patients management.

Methods Drainaige of pelvic abscess with lumen-apposing stent (Hot-Axios).

Results 54-year-old patient diagnosed of acute colonic diverticulitis complicated with abdominal collections: two of them located in the right iliac fossa (50 mm both) were treated with percutaneous drainage (8Fr pig-tail); another (60 x 50 mm) located between the bladder and rectum which was drained EUS-guided. Collection with echogenic content was located 13 cm proximal to the anal canal. A Hot Axios stent (10 mm) was placed between collection and rectal lumen draining pus. Control abdominal CT 20 days after placing the stent showed complete collections resolution so Axios stent was removed at day 21th. The patient remains asymptomatic and surgical treatment has not been required.

Conclusions Pelvic abscess treatment has historically been surgical and/or percutaneous drainage. Recently, EUS-guided drainage of pelvic collections has proven to be effective and safe, that is why it should be considered as a valid alternative to conventional techniques.