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. 2018 May-Jun;24(3):146-152.
doi: 10.5152/dir.2018.16500.

Pelvic abscess drainage: outcome with factors affecting the clinical success

Devrim Akıncı  1 , Onur Ergun  2 , Çağdaş Topel  1 , Türkmen Çiftçi  1 , Okan Akhan  1
Affiliations

Pelvic abscess drainage: outcome with factors affecting the clinical success

Devrim Akıncı et al. Diagn Interv Radiol. 2018 May-Jun.

Abstract

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

Methods: During a 7-year period, 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. Abscess characteristics (etiology, number, size, intrastructure, microbiological content, presence of fistula), patient demographics (age, sex, presence of malignancy, primary disease, antibiotic treatments), procedure-related factors (guidance method, access route, catheter size) 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 the cavity extended catheter duration (P < 0.001, P = 0.018, and P = 0.007, respectively), whereas the presence of sterile abscess and endocavitary catheterization reduced the catheter duration (P = 0.009 and 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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Conflict of interest statement

Conflict of interest disclosure

The authors declared no conflicts of interest.

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