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Sonographically Guided Transvaginal or Transrectal Pelvic Abscess Drainage Using the Trocar Method with a New Drainage Guide Attachment

¹ Both authors: Department of Radiology, University of California, Davis Medical Center, 4860 Y St., Ste. 3100, Sacramento, CA 95817.

View larger version (145K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —66-year-old woman (patient 3 in Table 1) who had undergone surgical resection for diverticulitis presenting with possible pelvic abscesses for endovaginal drainage. Contrast-enhanced CT scan shows fluid collection (A) posterior to uterus (U). B = bladder.

View larger version (50K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —Drainage guide attachment. Drainage guide attachment consists of two components: uncovered biopsy guide with catheter channel (curved arrow) and cover (straight arrow).

View larger version (32K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —Drainage guide attachment. Cover (straight arrow) is slid into groove covering catheter channel of drainage guide attachment (curved arrow). Affixed two components of system are then attached to endoluminal probe.

View larger version (34K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —Trocar catheter deployment. Once system is assembled, trocar catheter (arrow) is placed through covered channel on this drainage guide attachment and placed into fluid collection.

View larger version (26K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —Trocar catheter deployment. After catheter placement, cover is removed and catheter (arrow) stays in place while guide and ultrasound probe are removed.

View larger version (35K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —66-year-old woman (patient 3 in Table 1; same patient as shown in Fig. 1) who had undergone surgical resection for diverticulitis presenting with possible pelvic abscesses for endovaginal drainage. Endovaginal sonogram to localize fluid collection (A) and color used to avoid vessels (arrow) in path of trocar catheter.

View larger version (86K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —66-year-old woman (patient 3 in Table 1; same patient as shown in Fig. 1) who had undergone surgical resection for diverticulitis presenting with possible pelvic abscesses for endovaginal drainage. Trocar catheter (arrow) is placed using endovaginal route.

View larger version (101K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —66-year-old woman (patient 3 in Table 1; same patient as shown in Fig. 1) who had undergone surgical resection for diverticulitis presenting with possible pelvic abscesses for endovaginal drainage. Catheter is pushed from its stiffening cannula and Cope loop (arrow) is formed. Cover of guide is removed, then catheter is left in place and ultrasound guide and probe are removed.

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