TRANSRECTAL DRAINAGE OF DEEP PELVIC COLLECTIONS UNDER FLUOROSCOPIC GUIDANCE

Although transrectal drainage of pelvic fluid collections, guided by f luoroscopy, computed tomography (CT) and ultrasonography (US), has bee n reported, the cumulative experience is small. The authors describe a technique for fluoroscopically guided transrectal drainage and presen t the results obtained for 13 patients. Each patient underwent diagnos tic CT and then fluoroscopically guided drainage. A barium enema tube assembly, consisting of an enema tube, a Lunderquist PTC (percutaneous transhepatic cholangiogram) needle and a small portion of a red rubbe r catheter, was used to facilitate insertion of the drainage catheter. The procedure was defined as successful if complete clearance occurre d after drainage, as temporizing if partial drainage was achieved and clinical improvement occurred, and as failed if the collection showed no response to drainage. Twelve of the patients had abscesses, 9 of wh ich were successfully treated by drainage alone; one drainage was temp orizing and two failed. The collection in the last patient represented a hematoma, which did not respond to drainage. The authors conclude t hat the technique they describe is suitable for draining moderate to l arge pelvic abscesses. The procedure is safe and can easily be perform ed in both male and female patients.