DEEP PELVIC ABSCESSES - TRANSPERINEAL US-GUIDED DRAINAGE

PURPOSE: To examine the efficacy of transperineal sonographically guid ed drainage of deep pelvic abscesses. MATERIALS AND METHODS: Twelve dr ainage procedures were performed in 11 adults with symptoms of infecti on and cross-sectional images demonstrating a deep pelvic abscess. Eig ht patients had recently undergone abdominoperineal resection, seven o f whom underwent preoperative radiation therapy. Two had chronic osteo myelitis with adjacent fluid collections, and one developed an infecte d hematoma after trauma. With ultrasound (US) guidance for initial acc ess, catheters were placed for drainage in 11 procedures. One patient was treated with aspiration alone. Patients underwent clinical follow- up and subsequent imaging as necessary. RESULTS: Transperineal needle placement was successful in 12 of 12 patients (100%). In procedures th at required catheter placement, 10 of 11 placements (91%) were achieve d with the transperineal approach. One patient required fluoroscopic t ransvaginal catheter placement after opacification of the collection t ransperineally. Catheter drainage was maintained for 2-146 days (means , 40 days; median, 21 days). Clinical success was achieved in nine of 10 patients (90%) by means of transperineal drainage. There were no co mplications, although premature catheter removal occurred in two patie nts. CONCLUSION: US-guided transperineal abscess drainage may be succe ssfully performed in patients who cannot undergo conventional transabd ominal, transvaginal, or transrectal catheter drainage.