Percutaneous radiologic drainage of pelvic abscesses

Several radiologically-guided approaches to drainage of pelvic abscesses have been described in recent years. Previously, surgery was deemed the only option in many such cases. We employed these radiologic techniques in a heterogenous group of 32 patients. Ten patients in this group were drained by the transgluteal route; 12 transrectally (one transvaginally also) and ten via the presacral route. Twenty-four patients had abscess formation as a complication of recent abdomino-pelvic surgery; eight from other causes. Six patients had multiple abscesses. Technical success was achieved in 28/32 (88%) patients. No periprocedural complications were noted. Thirty-day mortality was 9% (three patients). Twenty-one patients (65%) improved clinically post procedure; 16 of them had no further surgical intervention. Five patients had surgery to treat underlying disease. Of the seven patients who did not improve, five underwent surgical drainage of whom two died from multi-organ failure. Three had successful surgery (one combined with further radiologic drainage). One patient had a second percutaneous drainage and the remaining patient died. The pelvic location of an abscess or collection should not preclude radiologically-guided drainage and clinicians should be aware of these techniques.