Transrectal ultrasound and fluoroscopy-guided drainage of deep pelvic collections in children
Abstract
Purpose
Pediatric deep pelvic abscesses generally occur as a complication of perforated appendicitis or after laparoscopic appendectomy. We describe our technique and experience in imaging-guided transrectal drainage (TRD) of deep pelvic abscesses in children.
Methods
From January 2005 to November 2008, imaging-guided TRD was attempted in 29 children. The procedure records and medical records were reviewed retrospectively.
Results
Twenty-nine TRD procedures were performed in 17 males and 12 female patients. The mean age was 11.8 years (range, 3.8-15.9 years). Fourteen patients required TRD after an abdominal operative procedure: laparoscopic appendectomy (n = 9), open appendectomy (n = 3), exploratory celiotomy for gunshot wound (n = 1), and exploratory celiotomy with intestinal resection for adhesive bowel obstruction (n = 1). Fifteen patients were referred for TRD as initial therapy for deep pelvic fluid collections: perforated appendicitis (n = 14) and Crohn perforation (n = 1). Twenty-seven (93.1%) procedures were successful, described as either placement of a TRD catheter or aspiration of the deep pelvic fluid using transrectal approach. There were no procedure-related complications.
Conclusions
Imaging-guided TRD in children is a safe and easy procedure that allows drainage of deep pelvic abscesses that are otherwise not easily accessible.
Key words: Transrectal drainage, Transrectal ultrasound, Deep pelvic abscess, Appendicitis, Children
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PII: S0022-3468(09)00553-3
doi:10.1016/j.jpedsurg.2009.06.033
© 2010 Elsevier Inc. All rights reserved.
