Percutaneous transgluteal drainage of pelvic abscesses in interventional radiology: A safe alternative to surgery

Aim: Interventional radiology plays an important role in the management of deep pelvic abscesses. Percutaneous drainage is currently considered as the first-line alternative to surgery. A transgluteal computed tomography (CT)-guided approach allows to access to deep infected collections avoiding many anatomical obstacles (vessels, nerves, bowel, bladder). The objective of this study was to assess the safety and efficacy of a transgluteal approach by reviewing our clinical experience. Materials and method: We reviewed medical records of patients having undergone percutaneous CT-guided transgluteal drainage for deep pelvic abscesses. We focused on the duration of catheter drainage, the complications related to the procedures and the rate of complete resolution. Results: Between 2005 and 2013, 39 patients (27 women and 12 men; mean age: 52.5) underwent transgluteal approach CT-guided percutaneous drainage of pelvis abscesses in our department. The origins of abscesses were postoperative complications in 34 patients (87.2%) and infectious intra-abdominal disease in 5 patients (12.8%). The mean duration of drainage was 8.3 days (range: 3-33). Laboratory cultures were positive in 35 patients (89.7%) and Escherichia coli was present in 71.4% of the positive samples. No major complication was observed. Drainage was successful in 38 patients (97.4%). A transpiriformis approach was more significantly associated with intra-procedural pain (P = 0.003). Conclusion: Percutaneous CT-guided drainage with a transgluteal approach is a safe, well-tolerated and effective alternative to surgery for deep pelvic abscesses. This approach should be considered as the first-line intention for the treatment of deep pelvic abscesses. (C) 2015 Elsevier Masson SAS. All rights reserved.