CT-guided Drainage of Deep Pelvic Abscesses via a Percutaneous Presacral Space Approach: A Clinical Report and Review of the Literature

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• 作者：Tao Peng ; MD^a ; Liming Dong ; MD^a ; ^b ; Zhihua Zhu ; MD^a ; Jing Cui ; MD^a ; Qian Li ; MD^c ; Xin Li ; MD^c ; Heshui Wu ; MD^a ; Chunyou Wang ; MD^a ; Zhiyong Yang ; PhD^a ; ^{Zhiyongyang77@163.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：CT-guided drainage ; deep pelvic abscesses ; presacral space
• 刊名：Academic Radiology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：23
• 期：12
• 页码：1553-1558
• 全文大小：996 K

文摘

Some deep pelvic abscesses are not accessible through anterior or lateral approaches because of the presence of organs and structures. The objective of this study was to assess the feasibility, safety, tolerability, and efficacy of a percutaneous presacral space approach by reviewing our clinical experience and the literature.

Materials and Methods

The outcomes of 12 patients, who have undergone computed tomography (CT)-guided percutaneous presacral space drainage, were retrospectively reviewed, including demographic, clinical, and morphological data in the medical records.

Results

From August 2010 to June 2015, 98 patients underwent CT-guided percutaneous drainage of pelvis abscesses in our institution. A percutaneous presacral space approach was adopted in 12 cases. The fluid collections were related to postoperative complications in nine patients (75%) and inflammatory or infectious intraabdominal disease in the remaining three patients (acute diverticulitis: n = 1; appendicitis: n = 1; Crohn disease: n = 1) (25%). The mean duration of drainage was 9.5 days (range 3–33). Escherichia coli was the most frequently present microorganism (in 50.0% of the all samples). No procedure-related complications were observed, either during or after the procedure. Drainage was successful in 10 patients (83.3%). Drainage failed in one patient because of massive anastomotic dehiscence. The other one died from pulmonary embolus 10 days after drainage.

Conclusions

When an anterior or lateral transabdominal approach is inaccessible, CT-guided transperineal presacral space approach drainage is a safe, well-tolerated, and effective procedure, except for patients with massive anastomotic dehiscence.