Journal ArticleDOI
Ultrasound-Guided Drainage of Deep Pelvic Abscesses: Experience With 33 Cases
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TLDR
It is concluded that ultrasound-guided transrectal, transvaginal, transperineal and transgluteal drainage of deep pelvic abscesses are safe and effective treatment approaches and needle drainage will be the most common first-line treatment approach.Abstract:
The aim of this study was to demonstrate and evaluate the ultrasound-guided drainage of deep pelvic abscesses in which transabdominal percutaneous access could not be performed because of overlying structures. A retrospective analysis of 32 consecutive patients with 33 deep pelvic abscesses was performed. The underlying causes of the abscesses included postsurgical fluid collection or surgical complications in 18 of the 32 patients, and 11 of these patients underwent recent rectal cancer surgery. The locations of the abscesses, which had a median diameter of 6 cm (range 2-10 cm), were as follows: perirectal (n=13), presacral (n=9), pouch of Douglas (n=7), internal genitals (n=2) and between the bowel loops (n=2). The abscesses were all drained using ultrasound (US) guidance with a transrectal (n=18), transvaginal (n=11), transperineal ( n=2) or transgluteal (n=2) approach. Of the larger abscesses (median diameter 7 cm), 19 were treated with catheter drainage and 18 of these cases resulted in favorable clinical outcomes. Of the smaller abscesses (median diameter 4 cm), 14 were treated with needle drainage. In two of these cases, follow-up US showed that a repeat puncture and drainage was necessary. All needle drainages resulted in favorable clinical outcomes. Sixteen of the 29 transrectal or transvaginal drainage procedures were performed without any anesthesia (10 were performed with a needle and six were performed with a catheter). Apart from minor discomfort during the drainage procedure and the subsequent in-dwelling catheter period, there were no serious complications related to the drainage procedures. We conclude that ultrasound-guided transrectal, transvaginal, transperineal and transgluteal drainage of deep pelvic abscesses are safe and effective treatment approaches. Based on our findings, needle drainage will be our most common first-line treatment approach because of the simplicity of the procedure, improved patient comfort and reduced costs. Catheter drainage will be reserved for large multiloculated abscesses.read more
Citations
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Journal ArticleDOI
EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III - Abdominal Treatment Procedures (Short Version).
Christoph F. Dietrich,T. Lorentzen,L. Appelbaum,Elisabetta Buscarini,Vito Cantisani,Jean Michel Correas,Xin-Wu Cui,Mirko D'Onofrio,Odd Helge Gilja,Michael Hocke,A. Ignee,Christian Jenssen,Adnan Kabaalioglu,Edward Leen,Carlos Nicolau,Christian Pállson Nolsøe,Maija Radzina,Carla Serra,Paul S. Sidhu,Zeno Sparchez,Fabio Piscaglia +20 more
TL;DR: Recommendations for clinical practice are presented covering indications, contraindications, safety and efficacy of the broad variety of ultrasound-guided and assisted interventions in abdominal treatment procedures.
Journal ArticleDOI
EFSUMB Position Paper: Recommendations for Gastrointestinal Ultrasound (GIUS) in Acute Appendicitis and Diverticulitis.
K. Dirks,Emma Calabrese,Christoph F. Dietrich,Odd Helge Gilja,Trygve Hausken,Antony Higginson,Alois Hollerweger,Giovanni Maconi,Christian Maaser,Dieter Nuernberg,Kim Nylund,Nadia Pallotta,Tomas Ripolles,Laura Romanini,Adrian Saftoiu,Carla Serra,Matthias Wüstner,Ioan Sporea +17 more
TL;DR: An interdisciplinary task force of European experts summarizes the value of gastrointestinal ultrasound (GIUS) in the management of acute appendicitis and diverticulitis and clinical recommendations for these highly common diseases in visceral medicine are presented.
EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III Abdominal Treatment Procedures (Long Version) EFSUMB Leitlinien interventioneller Ultraschall (INVUS), Teil III Ultraschall-geführte therapeutische Interventionen (Langversion)
C. F. Dietrich,T. Lorentzen,L. Appelbaum,Elisabetta Buscarini,Vito Cantisani,Jean Michel Correas,O. H. Gilja,M. Hocke,A. Ignee,C. Jenssen,Edward Leen,Carlos Nicolau,C. P. Nolsøe,Maija Radzina,Carla Serra,Paul S. Sidhu,Z. Sparchez,F. Piscaglia +17 more
TL;DR: Recommendations for clinical practice are presented covering indications, contra- indications, and safe and effective performance of the broad variety of these techniques.
Journal ArticleDOI
EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3: Endorectal, Endoanal and Perineal Ultrasound
Dieter Nuernberg,Adrian Saftoiu,Ana Paula Barreiros,Eike Burmester,Elena Tatiana Ivan,Dirk-André Clevert,Christoph F. Dietrich,Odd Helge Gilja,T. Lorentzen,Giovanni Maconi,Ismail Mihmanli,Christian Pállson Nolsøe,Frank Pfeffer,Søren Rafael Rafaelsen,Zeno Sparchez,Peter Vilmann,Jo Erling Riise Waage +16 more
TL;DR: Both ERUS and PNUS are considered excellent guidance methods for invasive interventions, such as the drainage of fluids or targeted biopsy of tissue lesions, and contrast-enhanced ultrasound (CEUS) also helps in therapy planning.
Journal ArticleDOI
Effectiveness of Endoluminal Vacuum-assisted Closure Therapy (Endosponge) for the Treatment of Pelvic Anastomotic Leakage After Colorectal Surgery.
TL;DR: This was a retrospective study of 15 cases involving the application of the Endo-SPONGE for anastomotic leakage following proctectomy between May 2009 and May 2014, where Lumen integrity was achieved in 12 cases.
References
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Percutaneous Abscess Drainage: Update
Eric vanSonnenberg,Gerhard R. Wittich,Brian W. Goodacre,Giovanna Casola,Horacio B. D'Agostino +4 more
TL;DR: Percutaneous abscess drainage is the prototype interventional radiology procedure, providing detection of the abscess by imaging, needling for diagnosis, and catheterization for therapy.
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The Inaccessible or Undrainable Abscess: How to Drain It
Michael M. Maher,Debra A. Gervais,Mannudeep K. Kalra,Brian C. Lucey,Dushyant V. Sahani,Ronald S. Arellano,Peter F. Hahn,Peter R. Mueller +7 more
TL;DR: Well-established alternative approaches (eg, transgluteal, transvaginal, transrectal) can be used to facilitate drainage of deep-seated collections that are inaccessible via more traditional routes and can allow percutaneous drainage of less accessible intraabdominal abscesses, thus eliminating the need for laparotomy.
Journal ArticleDOI
CT-guided transgluteal drainage of deep pelvic abscesses: indications, technique, procedure-related complications, and clinical outcome.
Mukesh G. Harisinghani,Debra A. Gervais,Peter F. Hahn,Chie Hee Cho,Kartik S. Jhaveri,Jose C. Varghese,Peter R. Mueller +6 more
TL;DR: Transgluteal drainage of deep pelvic abscesses is a useful option in pediatric patients and requires a thorough understanding of the anatomy of the sciatic foramen region and associated anatomic structures.
CT-guided Transgluteal Drainage of Deep Pelvic Abscesses: Indications, Technique, Procedure- related Complications,
Mukesh G. Harisinghani,Debra A. Gervais,Peter F. Hahn,Chie Hee Cho,Kartik S. Jhaveri,Jose C. Varghese,Peter R. Mueller +6 more
Journal ArticleDOI
US-guided transvaginal drainage of pelvic abscesses and fluid collections.
Eric vanSonnenberg,H B D'Agostino,Giovanna Casola,Brian W. Goodacre,R B Sanchez,Beth A. Taylor +5 more
TL;DR: US-guided transvaginal drainage in early experience suggest its use as an alternative to standard percutaneous catheter procedures to diagnose and drain certain pelvic abscesses and fluid collections.