Case l: A 56-year-old male with an entro-enterostomy for small bowel perforation during chemotherapy for malignant lymphoma presented with fever. Computed tomography (CT) showed a 7-cm pelvic abscess adjacent to the rectum, which was drained via rectal puncture using a 19-gauge needle with endoscopic ultrasound (EUS) guidance and a 6Fr drainage tube. The patient became afebrile rapidly, and the abscess decreased significantly on follow-up CT. The tube was removed a week later after his symptoms resolved. Case 2: A 66-year-old male with a laparoscopic appendectomy presented with fever. EUS revealed perirectal fluid collection. CT revealed a 4-cm pelvic abscess, which was drained via rectal puncture using a 19-gauge EUS-FNA needle. The cavity was flushed with saline until the return was clear and the cavity size decreased. The needle was removed with recovery.
