Deep pelvic abscesses in children: transrectal drainage under radiologic guidance.

Abstract

To compare the effectiveness of radiologically guided transrectal drainage (TRD) of deep pelvic abscesses (DPAs) in children with that of percutaneous and surgical techniques. Treatment results in 57 children with DPAs were retrospectively evaluated. The following procedures were performed: TRD alone (n = 21), TRD and percutaneous drainage (PD) of multiple abscesses (n = 5), PD alone (n = 19), and open surgical drainage (SD) (n = 8). Four patients were treated medically. Most abscesses were due to either perforated appendix or recent appendectomy. Patients believed to have a perforated appendix underwent interval appendectomy 4-6 weeks after TRD or PD. All patients recovered fully. TRD was tolerated better than PD or SD. Patients were usually ambulatory within 24 hours of the TRD procedure and required minimal analgesia. The average hospital stay was 4.2 days with TRD, 8 days with TRD and PD, 6 days with PD, and 10.5 days with SD. Radiologically guided TRD is effective in the treatment of DPAs.