Image-guided transvaginal drainage of pelvic abscesses and fluid collection using a modified Seldinger technique.
BACKGROUND
Transvaginal drainage using the trocar method is advantageous as a single-step procedure; however, the procedure may occasionally be difficult to perform, due to buckling of the catheter in the elastic vaginal tissues, despite the presence of a stiff stylet.


OBJECTIVE
To evaluate the efficacy and the safety of image-guided transvaginal drainage of pelvic abscesses and fluid collection using a modified Seldinger technique.


METHODS
Fifteen patients (mean age 43 years, range 24-82 years) who underwent transvaginal aspiration (n=1) or catheter drainage (n=14) guided by ultrasound and fluoroscopy were enrolled in this retrospective study. A small coronal incision was performed to facilitate puncture using an 18G needle, tract dilatation, and the insertion of a drainage catheter by the Seldinger technique. Outcome was analyzed with respect to clinical success, technical success, and procedure-related complications.


RESULTS
The overall clinical success rate was 87% (13/15 cases). The success rate of catheter drainage was 86% (12/14 cases), and the use of aspiration alone was successful in one patient. Technical success was achieved in all patients, without procedure-related complications.


CONCLUSIONS
Image-guided transvaginal drainage with a modified Seldinger technique can be a safe and effective alternative treatment for pelvic abscesses and fluid collection.
Ho Kim
Seung
S
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Hyup Kim
Seung
S
Han
Heon
H
Soo Kim
Sam
S
Yeon Lee
Ji
J
Hwan Jeon
Yong
Y
D000038:Abscess / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000295:instrumentation; D003287:Contrast Media / Q000008:administration & dosage; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D034161:Pelvic Infection / Q000628:therapy*; D010388:Pelvis / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D014621:Vagina / Q000601:surgery
D003287:Contrast Media