Luciano Tarantino MD, Presenter: Nothing to Disclose

Ignazio Francesco Maria Sordelli MD, Abstract Co-Author: Nothing to Disclose

evaluation of US guided drainage (US-D) in the treatment of pelvic abscesses (PA).

We retrospectively reviewed the clinical and imaging records of 62 patients (14 men, 48 women, aged 13-87 years) with a diagnosis of PA (37 post-surgical, 14 diverticulitis related, 2 following interventional procedure in the pelvis, and 9 cryptogenic) treated with US-D. 40 patients underwent trans-abdominal approach, 21 trans-vaginal route and one trans-perineal approach under trans-rectal US guidance. 39/62 patients (63 %), with PA size ranging 2.5 – 5.0 cm (mean = 4.2 cm), underwent needle drainage (US-ND) with 20-16-gauge Chiba needles . 23/62 patients (37 %) with PA size ranging 4.0 – 13.0 cm (mean= 6.5 cm), underwent drainage with a 7-12 French catheter (US-CD). All patients started therapy with Cephalosporin + metronidazole and/0r gentamycin . Catheters were removed within 3 to 12 days, when less than 20 ml daily discharge was observed. Patients were followed-up by US every 3 days, and discharged from the hospital when apyrexia and with evident progressive decrease of PA . Follow-up every 3 months was scheduled in all patients

US-D was effective in 60/62 (97 %) patients. 1 patient with a solid tubo-ovarian mass and 1 patient with a colonic fistula had respectively an unsuccessful transvaginal US-ND and an unsuccessful transabdominal US-CD. Both patients underwent surgery. There was no statistically significant difference in success rate between US-ND (38/39= 97%) and US-CD (22/23 =95%), nor between abdominal (39/40 = 97%) and transvaginal route (20/21 = 95%). Hospital stay in patients treated with US-ND (range : 1- 5 days; mean 2.4) was significantly lower than in patients treated with US-CD ( range = 3-12 days; mean 5.5 days). Antibiotic therapy was changed after cultures of the aspirated specimens in 13/62 (21 %) patients. During follow-up (12- 82 months) no relapse occurred

US-D is an highly effective procedure for treatment of PA. Efficacy seems neither related to the access route (transvaginal or abdominal) or to the type of drainage (needle or catheter). The longer hospital stay after catheter drainage is probably related to larger size of PA in this subset of patients in our series.

Choice of Catheter or Needle and route of approach  for US-guided drainage of Pelvic Abscesses depends mainly on the operator experience since all procedures are highly effective.

Tarantino, L, Sordelli, I, Pelvic Abscess Drainage: Transabdominal versus Transvaginal Route and Needle versus Catheter Drainage.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6017474.html