American Journal of Roentgenology, Vol 162, 1227-1230, Copyright © 1994 by American Roentgen Ray Society

ARTICLES

Transrectal sonographically guided drainage of deep pelvic abscesses

AA Alexander, DJ Eschelman, LN Nazarian and J Bonn
Department of Radiology, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, PA 19107.

OBJECTIVE. As an alternative to traditional surgical transrectal and transgluteal drainage, we have examined the efficacy of transrectal sonographically guided drainage for deep pelvic abscesses not accessible by percutaneous transabdominal or transvaginal routes. SUBJECTS AND METHODS. In nine patients (five males and four females) 5- 51 years old, sonography or CT showed pelvic abscesses that were deemed unapproachable by percutaneous transabdominal or transvaginal routes because of interposed bowel (five patients), presacral location (two patients), or inability of the pediatric vagina to accommodate a transvaginal probe (one patient). One patient refused both transvaginal and transgluteal routes in preference to transrectal drainage. IV sedation (adults) or general anesthesia (children) was used for all drainages. A 7.5-MHz end-fire transrectal sonographic probe fitted with a biopsy guide was inserted into the rectum, and the collection was localized. With sonographic guidance, an 18-gauge needle and then a guidewire were advanced into the collection. Then with fluoroscopic guidance, a self-retaining drainage catheter was placed by using the Seldinger technique. RESULTS. All nine collections were successfully accessed and effectively drained without complication. Catheters were removed after 1-24 days (mean, 7 days; median, 5 days) without recurrent abscesses. CONCLUSION. Transrectal sonographically guided drainage of deep pelvic abscesses is a safe, well-tolerated, effective alternative to the more traditional surgical transrectal drainage or transgluteal approach, especially in pelvic abscesses that cannot be safely drained via a percutaneous transabdominal or transvaginal route.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. G. Harisinghani, D. A. Gervais, M. M. Maher, C. H. Cho, P. F. Hahn, J. Varghese, and P. R. Mueller Transgluteal Approach for Percutaneous Drainage of Deep Pelvic Abscesses: 154 Cases Radiology, September 1, 2003; 228(3): 701 - 705. [Abstract] [Full Text] [PDF]

				E. Walser, S. Raza, A. Hernandez, O. Ozkan, M. Kathuria, and D. Akinci Sonographically Guided Transgluteal Drainage of Pelvic Abscesses Am. J. Roentgenol., August 1, 2003; 181(2): 498 - 500. [Full Text] [PDF]

				B. C. Lee, J. P. McGahan, and B. Bijan Single-Step Transvaginal Aspiration and Drainage for Suspected Pelvic Abscesses Refractory to Antibiotic Therapy J. Ultrasound Med., July 1, 2002; 21(7): 731 - 738. [Abstract] [Full Text] [PDF]

				J. C. Varghese, M.-J. O'Neill, D. A. Gervais, G. W. Boland, and P. R. Mueller Transvaginal Catheter Drainage of Tuboovarian Abscess Using the Trocar Method: Technique and Literature Review Am. J. Roentgenol., July 1, 2001; 177(1): 139 - 144. [Full Text] [PDF]

				D. M. Hovsepian, J. R. Steele, C. S. Skinner, and E. S. Malden Transrectal versus Transvaginal Abscess Drainage: Survey of Patient Tolerance and Effect on Activities of Daily Living Radiology, July 1, 1999; 212(1): 159 - 163. [Abstract] [Full Text]