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CT-Guided Transgluteal Drainage of Deep Pelvic Abscesses in Children

Selective Use as an Alternative to Transrectal Drainage

Debra A. Gervais1, Peter F. Hahn, Mary J. O'Neill and Peter R. Mueller

1 All authors: Department of Radiology, Abdominal Radiology Division, Massachusetts General Hospital, White 270, 32 Fruit St., Boston, MA 02114.



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  		Fig. 1A. —6-year-old girl with abscess after surgery. Axial CT scan through pelvis shows deep pelvic abscess (long arrow). Safe percutaneous access is precluded anteriorly by bladder (solid short arrow) and colon (solid curved arrow) and laterally by iliac vessels (curved open arrow) and bone (short open arrow).

 


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  		Fig. 1B. —6-year-old girl with abscess after surgery. CT scan shows catheter was placed (long arrow) via greater sciatic foramen. Sciatic nerve is not seen but courses along lateral aspect of foramen (short arrow).

 


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  		Fig. 2A. —7-year-old girl with appendicitis and abscess. Axial CT scan through pelvis shows anterior and lateral approaches to abscess (long arrow) are precluded by bladder (short arrow) and bowel (curved open arrow). Guiding needle was advanced via transgluteal approach (curved solid arrow).

 


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  		Fig. 2B. —7-year-old girl with appendicitis and abscess. Axial CT scan shows catheter (arrow) placed tandem to needle. Abscess is resolved.

 

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