Percutaneous drainage as an rapid procedure for deep pelvic abscess in the emergency department

BACKGROUND: Drainage of pelvic abscesses is interventional procedures that should be well planned due to organ contiguity. There are not enough publications in the literature evaluating the treatment methods of pelvic abscess drainage and comparing success rates. METHODS: In this study, 15 patients who underwent pelvic abscess drainage in our interventional radiology unit between June 2017 and December 2019 were retrospectively included. Abscess size, abscess characteristics, the method of access to abscess (transrectal, transvaginal, transgluteal), and drainage treatment procedure (needle aspiration, catheter treatment) were evaluated statistically in terms of effects on the success of treatment. RESULTS: Of the 15 patients included in the study, 6 (40%) were male and 9 (60%) were female, with a mean age of 31.6 years.In 2 of the patients treated with needle aspiration alone, the abscess collection was repeated and the second procedure was performed. In our study, the technical success was 100% and the complete clinical success was 80%. None of the patients underwent open surgery due to abscess after drainage treatment. CONCLUSION: In conclusion, endocavitary and percutaneous drainage treatments of pelvic abscesses are safe and effective treatment methods. The success of needle aspiration treatment is lower than catheter treatment and it should be considered that the abscess collection may recur.

Acil serviste derin pelvik apse için hızlı işlem: Perkütan drenaj

AMAÇ: Pelvik apselerin drenajı, organ yakınlığı nedeniyle iyi planlanması gereken girişimsel prosedürlerdir. Literatürde pelvik apse drenajının tedavi yöntemlerini değerlendiren ve başarı oranlarını karşılaştıran yeterli yayın bulunmamaktadır. GEREÇ VE YÖNTEM: Bu çalışmaya Haziran 2017 ve Aralık 2019 tarihleri arasında girişimsel radyoloji birimimizde pelvik apse drenajı yapılan 15 hasta geriye dönük olarak alındı. Apse büyüklüğü, apse özellikleri, apse erişim yöntemi (transrektal, transvajinal, transgluteal) ve drenaj tedavi prosedürü (iğne aspirasyonu, kateter tedavisi) tedavinin başarısı üzerindeki etkiler açısından istatistiksel olarak değerlendirildi. BULGULAR: Çalışmaya alınan 15 hastanın altısı (%40) erkek, dokuzu (%60) kadın olup ortalama yaşları 31.6 yıldı. Sadece iğne aspirasyonu ile tedavi edilen hastaların ikisinde apse koleksiyonu tekrarladı ve ikinci işlem yapıldı. Çalışmamızda teknik başarı %100 ve tam klinik başarı %80 idi. Hiçbir hastaya drenaj tedavisi sonrası apse nedeniyle açık cerrahi uygulanmadı. TARTIŞMA: Sonuç olarak, pelvik apselerin endokaviter ve perkütan drenaj tedavileri güvenli ve etkili tedavi yöntemleridir. İğne aspirasyon tedavisinin başarısı kateter tedavisinden daha düşüktür ve apse koleksiyonunun tekrarlayabileceği göz önünde bulundurulmalıdır. Anahtar sözcükler: Başarı; drenaj; erişim noktası; komplikasyon; pelvik abse; perkütan; transgluteal; transrektal; transvajinal

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