Endoscopic ultrasound-guided pelvic abscess drainage: a report of 2 cases and literature review

Abstract

Background Drainage is essential for source control of the infection in a pelvic abscess. The purpose of this study was to report 2 cases of endoscopic ultrasound (EUS)-guided drainage of the pelvic abscess and review the literature of different modalities of EUS-guided drainage of pelvic abscess.

Case presentation A 60-year-old male developed a pelvic abscess 1 month after laparoscopic complete tumor resection. An abdominal CT showed a mass shadow (about 7.1 cm × 5.1 cm) in the right pelvic region. Another case was an 85-year-old male who developed a pelvic abscess 3 days after recurrent tumor resection of multiple organs. The CT showed pelvic effusion and gas accumulation (approximately 6.5 cm × 4.2 cm), and the intestinal tube above the small intestinal anastomosis was dilated with effusion. A 19G-A puncture needle was used to puncture the abscess. An 8-mm cylindrical balloon was inserted, followed by a 10 Fr-3 cm double pigtail stent and an 8.5 Fr drainage tube. After EUS-guided drainage of pelvic abscess, the symptoms disappeared without recurrence.

Conclusions EUS-guided drainage is an effective and safe method for treating pelvic abscesses as long as the drainage modality is appropriately selected based on the etiology, size, and mucus viscosity of the abscess.

Zusammenfassung

Hintergrund Bei einem Beckenabszess ist eine Drainage zur Eindämmung der Infektionsquelle unabdingbar. In dieser Studie berichten wir über 2 Fälle einer endosonografisch gezielten Drainage eines Beckenabszesses und geben eine Literaturübersicht über die verschiedenen Modalitäten einer endosonografisch gezielten Drainage von Beckenabszessen.

Falldarstellung Ein 60-jähriger Mann entwickelte 1 Monat nach einer vollständigen laparoskopischen Tumorresektion einen Beckenabszess. Das CT zeigte einen Massenschatten (etwa 7,1 cm × 5,1 cm) im rechten Becken. In einem weiteren Fall entwickelte ein 85-jähriger Mann 3 Tage nach einer wiederholten Tumorresektion mehrerer Organe einen Beckenabszess. Das CT zeigte einen Erguss und eine Gasansammlung (ca. 6,5 cm × 4,2 cm) im Becken, und das Darmrohr oberhalb der Dünndarmanastomose war durch einen Erguss erweitert. Zur Punktion des Abszesses wurde eine 19G-A-Punktionsnadel verwendet. Es wurde ein zylindrischer 8-mm-Ballon eingeführt, gefolgt von einem 10Fr-3-cm-Doppel-Pigtail-Stent und einem 8,5Fr-Drainageschlauch. Nach der endosonografisch gezielten Drainage des Beckenabszesses verschwanden die Symptome, es trat kein Rezidiv auf.

Schlussfolgerungen Die endosonografisch gezielte Drainage ist eine wirksame und sichere Methode zur Behandlung von Beckenabszessen, solange die Drainagemethode entsprechend der Ätiologie, Größe und Schleimviskosität des Abszesses passend ausgewählt wird.

Schlüsselwörter

Drainage - Beckenabszess - Ultraschall-gesteuerte Drainage - Drainagemethode - Symptome

Keywords

drainage - pelvic abscess - ultrasound-guided drainage - drainage modality - symptoms

Publication History

Received: 26 June 2021

Accepted after revision: 09 August 2021

Article published online:
12 October 2021

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