TWO CASES OF PELVIC ABSCESS IMPROVED BY ENDOSCOPIC ULTRASONOGRAPHY-GUIDED TRANSRECTAL DRAINAGE

Abstract

There are many reports of endoscopic ultrasound (EUS)-guided transrectal drainage of a pelvic abscess from Europe and the United States, but few cases from Japan. Here, we report two cases of pelvic abscess treated using this procedure. Case 1 involved a 42-year-old female. A pelvic abscess was found after surgery for gangrenous appendicitis. The abscess in Douglasʼs fossa was punctured through the vagina, but the patientʼs condition did not improve. We visualized the abscess from the rectum via EUS, punctured it with a 19-gauge EUS-fine needle aspiration needle, and placed external drainage catheters inside the abscess. The abscess nearly disappeared. Case 2 involved an 84-year-old female. A pelvic abscess was found after surgery for idiopathic rectal perforation. We treated the abscess using the same method as used for Case 1. In both cases, we removed the external drainage catheters after about one week, and complications and recurrence of abscess were not observed. These two cases show that EUS-guided transrectal drainage is effective for treating pelvic abscess.