Abstract
Background Currently, the methods for drainage of pelvic abscess primarily use computed tomography-
or ultrasound-guided percutaneous drainage or surgical drainage. Endoscopic ultrasound-guided
pelvic abscess drainage (EUS-PAD) is an alternative, minimally invasive tool to drain
an abscess, localized close to the rectum or left colon, and therefore not accessible
by other means.
Methods We report on the success of endoscopic ultrasound-guided drainage of peridiverticulitic
abscess based on the two cases presented here. Using endoscopic ultrasound guidance
an aspiration of the abscess from the endoluminal could be realized. After successive
balloon dilatation via a guidewire while using X-ray imaging, the placement of pigtail
or flap stent was performed. In addition, conservative therapy measures such as antibiotics,
diet, and pain management were performed.
Results The interventions were successful in both patients, resulting in rapid recourse of
discomfort, abscess size, and sepsis. After controlling the consequences of complicated
diverticulitis, both patients underwent laparoscopic sigmoid resection with primary
anastomosis and without ileostomy during an inflammation-free interval.
Conclusion Both cases demonstrate the advantages of EUS-PAD. A laparoscopic operation with primary
anastomosis, lower perioperative risk, and without need of a protective ileostomy
in early elective setting became possible by bridging the time until surgery by using
EUS-PAD.
Keywords
endoscopic ultrasound - pelvic abscess drainage - transrectal surgery - bridging to
surgery
