Transrectal Ultrasound Guided Drainage of Deep Pelvic Abscess in Females

Background: Percutaneous drainage is a standard treatment for patients with pelvic abscess. However deep abscess might be challenging for percutaneous root especially small volume collections which are relatively commoner in females in child bearing period being prone to a number of etiologies, commonest of which are postsurgical complications, pelvic inflammatory disease and complicated inflammatory bowel disease. Transrectal guidance allows drainage of the inaccessible deeply seated pelvic collections due to close proximity to the collection. We favor aspiration over drainage catheter insertion to avoid fistulation and patient inconvenience. To assess the technical and clinical success or the transrectal ultrasound guided drainage of deep pelvic abscess in females. Method(s): From January 2015 to October 2018; 34 female patients were presented to Ain Shams University Interventional Radiology Unit for deep pelvic abscess drainage. A 14 G 25 cm needle was introduced through adapter over a the endocavitary probe. Complete aspiration was always tried with irrigation with normotonic saline till aspirate clearance. Local injection of broad spectrum antibiotic was injected before removal of the needle. Result(s): Technical success defined as ability to completely aspirate the abscess was achieved in 30 patient (88%). In 3 patients abscess could not be aspirated completely due to relatively large volume, and 1 patient due to markedly thick abscess content necessitating surgical drainage. Clinical success defined as no recurrence within the first 3 months was 86%. 4 cases had recurrence with procedure redo. 1 had second recurrence and referred for posterior colpotomy. No major complications were seen, minor self-limiting anal pain was noted in most of the cases and managed conservatively, minor self limiting rectal bleeding occurred in 3 cases. Conclusion(s): Transrectal US guided aspiration of deep pelvic abscess in females shows relatively high rates success with low rates of complications and should be tried before surgical drainage.

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Artikel online veröffentlicht:
11. Mai 2021