CT-guided paracoccygeal drainage of pelvic abscesses.
OBJECTIVE
Using the transrectal/transvaginal routes for the drainage of pelvic abscesses complicating colorectal surgery (anterior resection or abdominoperineal resection) is not always possible. The conventional transgluteal approach through the greater sciatic foramen, although proven to be a valuable access route, can have complications (mainly local pain).


METHODS
To avoid these difficulties, a CT-guided paracoccygeal-infragluteal approach was used in the percutaneous drainage of deep pelvic (presacral and ischiorectal) abscesses presenting after colorectal surgery in six patients.


RESULTS
Percutaneous drainage through this approach was successful in preventing the need for surgery in all six patients. No complications or recurrences were noted, and catheters were removed an average of 15 days after insertion.


CONCLUSIONS
In comparison with the classical transgluteal approach, the paracoccygeal-infragluteal approach minimizes patient discomfort and minimizes the risk of potential injury to the sciatic plexus or blood vessels. This initial series shows that a CT-guided paracoccygeal-infragluteal approach is well tolerated, safe, and effective for the percutaneous drainage of pelvic abscesses developing after colorectal surgery.
Longo
J M
JM
Department of Radiology, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain.
Bilbao
J I
JI
deVilla
V H
VH
Iglesias
A
A
Pueyo
J
J
Lecumberri
F J
FJ
Cienfuegos
J A
JA
D000005:Abdomen / Q000601:surgery; D000038:Abscess / Q000000981:diagnostic imaging / Q000628:therapy*; D000328:Adult; D000368:Aged; D004322:Drainage / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging; D010502:Perineum / Q000601:surgery; D011183:Postoperative Complications; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed