CT guided percutaneous transgluteal drainage of pelvic collections is a useful procedure for a radiologist in a district general hospital

Abstract

Purpose Percutaneous, image-guided drainage is the treatment of choice for most pelvic abscesses. Deep pelvic abscesses can be drained using low anterior abdominal wall, transgluteal, per rectal or per vaginal approaches. We favour a CT-guided percutaneous transgluteal route to drain these. We report our techniques for drainage and outcomes for 12 patients. Methods and materials A search of the Royal Alexandra Hospital (RAH) radiology information system (RIS) showed 15 transgluteal drainages in the past seven years. All case notes were retrieved and reviewed for patient and drainage details, and outcome post drainage. Results The study looked at 12 patients who had 15 transgluteal drainages. Mean patient age was 59 years; range 26–91 years; male:female = 1:1. Half of the patients had a pelvic collection following surgery (n = 6). Other causes included perforated duodenal ulcer (n = 2), perforated appendicitis (n = 1), perforated gall bladder (n = 1), perforated colon at colonoscopy (n = 1) and recurrent pelvic sepsis of unknown cause (n = 1). Mean duration of drainage was eight days but ranged from 3–16 days. There were no periprocedural complications or deaths. No patient required subsequent surgery. Conclusion CT guided, percutaneous transgluteal drainage of deep pelvic abscesses is a straightforward procedure with few complications and suitable for widespread usage in district general hospitals. This was the definitive procedure for our 12 patients with deep pelvic abscess. Percutaneous, image-guided drainage is the treatment of choice for most pelvic abscesses. Deep pelvic abscesses can be drained using low anterior abdominal wall, transgluteal, per rectal or per vaginal approaches. We favour a CT-guided percutaneous transgluteal route to drain these. We report our techniques for drainage and outcomes for 12 patients. A search of the Royal Alexandra Hospital (RAH) radiology information system (RIS) showed 15 transgluteal drainages in the past seven years. All case notes were retrieved and reviewed for patient and drainage details, and outcome post drainage. The study looked at 12 patients who had 15 transgluteal drainages. Mean patient age was 59 years; range 26–91 years; male:female = 1:1. Half of the patients had a pelvic collection following surgery (n = 6). Other causes included perforated duodenal ulcer (n = 2), perforated appendicitis (n = 1), perforated gall bladder (n = 1), perforated colon at colonoscopy (n = 1) and recurrent pelvic sepsis of unknown cause (n = 1). Mean duration of drainage was eight days but ranged from 3–16 days. There were no periprocedural complications or deaths. No patient required subsequent surgery. CT guided, percutaneous transgluteal drainage of deep pelvic abscesses is a straightforward procedure with few complications and suitable for widespread usage in district general hospitals. This was the definitive procedure for our 12 patients with deep pelvic abscess.