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Use of an Amplatz dilator to facilitate transrectal abscess drainage in children
David D Sheyn1, John M Racadio, Judy M Racadio
1Department of Radiology, Division of Pediatric Interventional Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229-3030, USA.
Insights
This study presents a novel image-guided transrectal drainage technique for pediatric deep pelvic abscesses. The method utilizes transabdominal ultrasound and the Seldinger technique for effective catheter placement, offering an improved approach.
Area of Science:
- Pediatric surgery
- Interventional radiology
- Medical device technology
Background:
- Deep pelvic abscesses in children pose treatment challenges.
- Current transrectal drainage methods have limitations.
- Image guidance is crucial for deep pelvic abscess management.
Purpose of the Study:
- To describe a novel image-guided transrectal catheterization technique for pediatric deep pelvic abscesses.
- To evaluate the feasibility and application of this technique.
- To address limitations of existing transrectal drainage methods.
Main Methods:
- Transabdominal ultrasound guidance for transrectal catheter advancement.
- Use of an Amplatz dilator with coaxial metal cannula and inner trocar.
- Pigtail catheter placement via Seldinger technique.
- Single-institutional experience with 13 pediatric patients.
Main Results:
- Successful transrectal catheter introduction and abscess drainage was achieved.
- The described technique demonstrated feasibility in 13 pediatric cases.
- This method offers an alternative to existing transrectal drainage approaches.
Conclusions:
- The described image-guided transrectal drainage technique is effective for pediatric deep pelvic abscesses.
- This approach offers advantages over other transrectal methods.
- Further evaluation in a larger cohort is warranted.
Abstract:
Image-guided transrectal drainage is an effective treatment option for many deep pelvic abscesses in children. Currently, a variety of imaging and catheter techniques are used to access and drain these abscesses. The present report describes an approach for introducing the transrectal catheter by using transabdominal ultrasound guidance to direct transrectal advancement of an Amplatz dilator with coaxial placement of the metal cannula and inner trocar from a pigtail catheter set, followed by placement of the pigtail catheter via Seldinger technique. This approach eliminates some of the limitations of other transrectal techniques. The present report describes a single-institutional experience with this technique in 13 patients.