CT-Guided transgluteal approach for percutaneous drainage of pelvic abscesses: results in 21 patients

Objective. - Percutaneous drainage of pelvic abscesses may be challenging using a conventional anterior route because of overlying intestinal or vascular structures. Although, the posterior transgluteal route is not commonly performed, it may provide a safer approach when the conventional anterior route is not feasible. We retrospectively analyzed our experience in transgluteal percutaneous drainage of pelvic abscesses in 21 patients to determine the feasibility, safety, tolerance and efficacy of this technique. Methods. - The data of 21 patients with pelvic abscesses (15 postoperative and 6 secondary to diverticulitis) who were treated by CT-guided percutaneous transgluteal drainage between 1992 and 2002 were reviewed. Transgluteal drainage was considered as failure in case of persisting clinical sepsis, recurrence of abscess or when surgery was needed. Results. - The procedure was well tolerated in all patients. No major complication was observed. In one patient mild hematoma of the piriform muscle was noticed on postprocedure CT scan but did not require a specific treatment. Successful drainage as documented by follow-up CT examination was observed in 20 patients (20/21; 95%). One case of recurrence which was successfully treated by repeated percutaneous transgluteal drainage was observed in our series. Conclusion. - Percutaneous imaging-guided transgluteal drainage is a feasible, safe, well-tolerated and effective method for the treatment of pelvic abscess when a conventional anterior route is not feasible. (c) 2005 Elsevier SAS. Tous droits reserves.