Abstract
Background
The purpose of this study is to demonstrate the feasibility, safety, and success of percutaneous paracoccygeal catheter drainage of deep pelvic abscesses using a combination of sonography and fluoroscopic guidance.
Methods
From April 2005 to December 2006, under sonography and fluoroscopic guidance, sixteen patients with deep pelvic abscess underwent percutaneous paracoccygeal drainage. The causes of pelvic abscesses were post-operative complications. The patient was in prone position; the puncture site was first evaluated with sonography. After local anesthesia, a thin needle (22 G) was positioned along the lateral margin of the coccyx to avoid an eventual injury of sciatic nerve or vessels into the deep pelvic abscess under sonography guidance. Small dose of contrast was injected under fluoroscopy to verify the needle. With Seldinger technique catheters were placed for drainage. Catheter drainage was maintained for 9–40 days. Patients underwent clinical follow-up and subsequent imaging as necessary.
Results
Neither significant complications nor technical failures were observed. A complete resolution of the abscess was achieved in 14 patients, and significant resolution of abscess was also observed in the other 2 patients.
Conclusions
Sonography and fluoroscopic guided percutaneous paracoccygeal drainage is safe, feasible and efficient approach in the treatment of deep pelvic abscess.
Similar content being viewed by others
References
Harisinghani MG, Gervais DA, Hahn PF, et al. (2002) CT-guided transgluteal drainage of deep pelvic abscesses: indications, technique, procedure-related complications, and clinical outcome. Radiographics 22:1353–1367
Walser E, Raza S, Hernandez A, et al. (2003) Sonographically guided transgluteal drainage of pelvic abscesses. Am J Roentgenol 181:498–500
Maher MM, Gervais DA, Kalra MK, et al. (2004) The inaccessible or undrainable abscess: how to drain it. Radiographics 24:717–735
Bennett JD, Kozak RI, Taylor BM, et al. (1992) Deep pelvic abscesses: transrectal drainage with radiologic guidance. Radiology 185:825–828
Lee BC, McGahan JF, Bijan B. (2002) Single-step transvaginal aspiration and drainage for suspected pelvic abscesses refractory to antibiotic therapy. J Ultrasound Med 21:731–738
O’Neill MJ, Rafferty EA, Lee SI, et al. (2001) Transvaginal interventional procedures: aspiration, biopsy, and catheter drainage. Radiographics 21:657–672
Sperling DC, Needleman L, Eschelman DJ, et al. (1998) Deep pelvic abscesses: transperineal US-guided drainage. Radiology 208:111–115
Hovsepian DM, Steele JR, Skinner CS, et al. (1999) Transrectal versus transvaginal abscess drainage: survey of patient tolerance and effect on activities of daily living. Radiology 212:159–163
Feld R, Eschelman DJ, Sagerman JE, et al. (1994) Treatment of pelvic abscesses and other fluid collections: efficacy of transvaginal sonographically guided aspiration and drainage. Am J Roentgenol 163:1141–1145
Hanbige AE, Wilson SR. (2005) The peritoneum In: Rumack CM, Wilson SR (eds) Diagnostic ultrasound. Mosby, Missouri, pp 503–526
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lee, D.H., Kim, G.C., Ryeom, H.K. et al. Percutaneous paracoccygeal catheter drainage of deep pelvic abscesses using a combination of sonographic and fluoroscopic guidance. Abdom Imaging 33, 611–614 (2008). https://doi.org/10.1007/s00261-007-9272-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-007-9272-7