CT-GUIDED PARACOCCYGEAL DRAINAGE OF PELVIC ABSCESSES

Objective: Using the transrectal/transvaginal routes for the drainage of pelvic abscesses complicating colorectal surgery (anterior resectio n or abdominoperineal resection) is not always possible. The conventio nal transgluteal approach through the greater sciatic foramen, althoug h proven to be a valuable access route, can have complications (mainly local pain). Materials and Methods: To avoid these difficulties, a CT -guided paracoccygeal-infragluteal approach was used in the percutaneo us drainage of deep pelvic (presacral and ischiorectal) abscesses pres enting after colorectal surgery in six patients. Results: Percutaneous drainage through this approach was successful in preventing the need for surgery in all six patients. No complications or recurrences were noted, and catheters were removed an average of 15 days after insertio n. Conclusion: In comparison with the classical transgluteal approach, the paracoccygeal-infragluteal approach minimizes patient discomfort and minimizes the risk of potential injury to the sciatic plexus or bl ood vessels. This initial series shows that a CT-guided paracoccygeal- infragluteal approach is well tolerated, safe, and effective for the p ercutaneous drainage of pelvic abscesses developing after colorectal s urgery.