PELVIC FLUID COLLECTIONS - ANATOMY FOR INTERVENTIONAL PROCEDURES

The use of imaging-guided percutaneous interventional procedures has b ecome routine over the last 10 years. During the early experience with imaging-guided intervention, biopsies and drainages of many pelvic le sions were considered inappropriate for percutaneous procedures. This was often due to a lack of a safe access route.(1) Anteriorly, bowel a nd bladder limit access to deep pelvic lesions. Posteriorly and latera lly, the bony elements of the pelvis prevent easy access to pelvic les ions.(2) With advances both in imaging and interventional techniques, many of these previously ''unreachable'' lesions can now be safely acc essed. Knowledge of the imaging characteristics of pelvic lesions and of pelvic anatomy is essential for proper planning of an interventiona l procedure.(3) This chapter will discuss pelvic anatomy relevant to p erforming percutaneous procedures, specifically biopsies and abscess d rainages, along with specific anatomic considerations for various appr oaches to lesions in the pelvis.