Transrectal drainage of deep pelvic collections under fluoroscopic guidance

Although transrectal drainage of pelvic fluid collections, guided by fluoroscopy, computed tomography (CT) and ultrasonography (US), has been reported, the cumulative experience is small. The authors describe a technique for fluoroscopically guided transrectal drainage and present the results obtained for 13 patients. Each patient underwent diagnostic CT and then fluoroscopically guided drainage. A barium enema tube assembly, consisting of an enema tube, a Lunderquist PTC (percutaneous transhepatic cholangiogram) needle and a small portion of a red rubber catheter, was used to facilitate insertion of the drainage catheter. The procedure was defined as successful if complete clearance occurred after drainage, as temporizing if partial drainage was achieved and clinical improvement occurred, and as failed if the collection showed no response to drainage. Twelve of the patients had abscesses, 9 of which were successfully treated by drainage alone; one drainage was temporizing and two failed. The collection in the last patient represented a hematoma, which did not respond to drainage. The authors conclude that the technique they describe is suitable for draining moderate to large pelvic abscesses. The procedure is safe and can easily be performed in both male and female patients.