E-ISSN 1305-3612
Interventional Radiology - Original Article
Pelvic abscess drainage: results with factors affecting the clinical success
1 Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey  
2 Department of Radiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey  
Diagn Interv Radiol ; : -

Abstract

Purpose: To evaluate the success and complication rates of image-guided pelvic abscess drainage with emphasis on factors affecting the clinical success.

 

Methods: During the 7-year period, total 185 pelvic abscesses were treated in 163 patients under ultrasonography and fluoroscopy (n=140) or computed tomography (n=45) guidance with transabdominal (n=107), transvaginal (n=39), transrectal (n=21) and transgluteal (n=18) approaches. Factors including the abscess (etiology, number, size, intrastructure, microbiological content, presence of fistula), patient (age, sex, presence of malignancy, primary disease, being under antibiotic treatment) and procedure (guidance method, access route, catheter size) characteristics and their effects on clinical success, complications and duration of catheterization were statistically analyzed.

 

Results: Technical and clinical success rates were 100% and 93.9%, respectively. Procedure-related mortality or major complications were not observed. Minor complications such as catheter dislodgement, obstruction or kinking were detected in 6.7% of the patients. Clinical failure was observed in 10 patients (6.1%). Fistulization was observed in 14 abscesses. Fistulization extended the duration of catheter use (p<0.001) and decreased the clinical success rate (p<0.001). The presence of postoperative malignant, complex-multilocular abscesses and fungus infection in cavity extended catheter duration (p<0.001; p=0.018; p=0.007, respectively) whereas the presence of sterile abscess and endocavitary catheterization reduced the catheter duration (p=0.009; p=0.011, respectively).

 

 

Conclusion: Image-guided pelvic abscess drainage has high clinical success and low complication rates. The only factor affecting the clinical success rate is the presence of fistula. 

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