A CASE OF SUCCESSFUL ENDOSCOPIC ULTRASOUND (EUS)-GUIDED TRANSRECTAL DRAINAGE OF A PELVIC ABSCESS

Abstract

We report an 82-year-old woman with a pelvic abscess that was successfully treated by endoscopic ultrasound (EUS)-guided transrectal drainage. She presented to our emergency room with fever and lower abdominal pain two months after bilateral adnexectomy and hysterectomy for tubo-ovarian abscess. CT revealed an abscess cavity of 8 cm in diameter between the urinary bladder and the rectum. As the abscess was located close to the rectum and left colon wall, EUS-guided transrectal drainage was performed. EUS showed evidence of perirectal fluid collection, and the abscess was punctured with a 19-gauge EUS-FNA needle, followed by insertion of a 6Fr drainage catheter within the abscess cavity. She became afebrile within 24 hours after drainage and the size of the abscess decreased significantly on follow-up CT one week later. The external catheter was exchanged to a 7Fr internal stent, which was spontaneously expelled after 2 weeks. One month later, follow-up CT showed complete resolution of the abscess. EUS-guided transrectal drainage appears to be an effective non-surgical intervention for postoperative pelvic abscesses.