title: CT-guided Drainage of Deep Pelvic Abscesses via a Percutaneous Presacral Space Approach: A Clinical Report and Review of the Literature.
abstract: Some deep pelvic abscesses are not accessible through anterior or lateral approaches because of the presence of organs and structures. The objective of this study was to assess the feasibility, safety, tolerability, and efficacy of a percutaneous presacral space approach by reviewing our clinical experience and the literature.
  
  
  
  The outcomes of 12 patients, who have undergone computed tomography (CT)-guided percutaneous presacral space drainage, were retrospectively reviewed, including demographic, clinical, and morphological data in the medical records.
  
  
  
  From August 2010 to June 2015, 98 patients underwent CT-guided percutaneous drainage of pelvis abscesses in our institution. A percutaneous presacral space approach was adopted in 12 cases. The fluid collections were related to postoperative complications in nine patients (75%) and inflammatory or infectious intraabdominal disease in the remaining three patients (acute diverticulitis: n = 1; appendicitis: n = 1; Crohn disease: n = 1) (25%). The mean duration of drainage was 9.5 days (range 3-33). Escherichia coli was the most frequently present microorganism (in 50.0% of the all samples). No procedure-related complications were observed, either during or after the procedure. Drainage was successful in 10 patients (83.3%). Drainage failed in one patient because of massive anastomotic dehiscence. The other one died from pulmonary embolus 10 days after drainage.
  
  
  
  When an anterior or lateral transabdominal approach is inaccessible, CT-guided transperineal presacral space approach drainage is a safe, well-tolerated, and effective procedure, except for patients with massive anastomotic dehiscence.
authors.affiliation: Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Peng
authors.affiliation: Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, China; Department of Trauma Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan.
authors.forename: Liming
authors.initials: L
authors.lastname: Dong
authors.affiliation: Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Cui
authors.affiliation: Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, China.
authors.forename: Heshui
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, China.
authors.forename: Chunyou
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, China. Electronic address: Zhiyongyang77@163.com.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Yang
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D001064:Appendicitis / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery; D004238:Diverticulitis / Q000601:surgery; D004322:Drainage / Q000379:methods*; D004927:Escherichia coli Infections / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D034161:Pelvic Infection / Q000000981:diagnostic imaging / Q000601:surgery*; D010388:Pelvis / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: CT-guided drainage; deep pelvic abscesses; presacral space