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Zhang FL, Xu J, Jiang YH, Zhu YD, Wu QN, Shi Y, Zhan ZY, Wang H. Special stent for draining the abdominal abscess respectively from colon and duodenum: A case report. World J Clin Cases 2024; 12:3931-3935. [PMID: 38994300 PMCID: PMC11235422 DOI: 10.12998/wjcc.v12.i19.3931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/22/2024] [Accepted: 05/14/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Postoperative abdominal infections are an important and heterogeneous health challenge. Many samll abdominal abscesses are resolved with antibiotics, but larger or symptomatic abscesses may require procedural management. CASE SUMMARY A 65-year-old male patient who suffered operation for the left hepatocellular carcinoma eight months ago, came to our hospital with recurrent abdominal pain, vomit, and fever for one month. Abdominal computed tomography showed that a big low-density dumbbell-shaped mass among the liver and intestine. Colonoscopy showed a submucosal mass with a fistula at colon of liver region. Gastroscopy showed a big rupture on the submucosal mass at the descending duodenum and a fistula at the duodenal bulb. Under colonoscopy, the brown liquid and pus were drained from the mass with "special stent device". Under gastroscopy, we closed the rupture of the mass with a loop and six clips for purse stitching at the descending duodenum, and the same method as colonoscopy was used to drain the brown liquid and pus from the mass. The symptom of abdominal pain, vomit and fever were relieved after the treatment. CONCLUSION The special stent device could be effectively for draining the abdominal abscess respectively from colon and duodenum.
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Affiliation(s)
- Fu-Long Zhang
- Department of Gastroenterology, Hangzhou Xixi Hospital, Hangzhou 310023, Zhejiang Province, China
| | - Jing Xu
- Department of Hepatopathy, Hangzhou Xixi Hospital, Hangzhou 310023, Zhejiang Province, China
| | - Yu-Hong Jiang
- Department of Gastroenterology, Hangzhou Xixi Hospital, Hangzhou 310023, Zhejiang Province, China
| | - Yuan-Dong Zhu
- Department of Gastroenterology, Hangzhou Xixi Hospital, Hangzhou 310023, Zhejiang Province, China
| | - Qian-Neng Wu
- Department of Gastroenterology, Hangzhou Xixi Hospital, Hangzhou 310023, Zhejiang Province, China
| | - Yan Shi
- Department of Gastroenterology, Hangzhou Xixi Hospital, Hangzhou 310023, Zhejiang Province, China
| | - Zong-Yuan Zhan
- Department of Gastroenterology, Hangzhou Xixi Hospital, Hangzhou 310023, Zhejiang Province, China
| | - Hai Wang
- Department of Gastroenterology, Hangzhou Xixi Hospital, Hangzhou 310023, Zhejiang Province, China
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Jing X, Liu S, Tian Z, Jiang Y, Mao T, Ding X. Endoscopic ultrasound-guided drainage to abdominal abscess: A systematic review and meta-analysis. J Minim Access Surg 2022; 18:489-496. [PMID: 35915535 PMCID: PMC9632695 DOI: 10.4103/jmas.jmas_349_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Ultrasound (US)- or computed tomography-guided drainage for abdominal abscess is currently the first-line options for drainage, but both options have disadvantages. Patients without adequate windows for drainage mostly undergo surgical drainage. However, surgical drainage is invasive and expensive. Endoscopic US (EUS)-guided drainage is a minimally invasive alternative for abdominal abscess, but there is less consensus on its efficacy, safety and complications. This meta-analysis aims to evaluate EUS-guided drainage for abdominal abscess. Materials and Methods: We retrieved relevant papers on EUS-guided drainage for abdominal abscess from the PubMed, Cochrane Library, Web of Science and EMBASE databases. Each paper was reviewed, and data were extracted. We used R software version 3.6.3 to perform the meta-analysis. Fixed effects models were used for merging data. Results: A total of 11 papers met the inclusion criteria, with a total sample population of 264 patients. The meta-analysis showed that the pooled clinical success rate was 90% (95% confidence interval [CI], 0.85–0.95), the technical success rate was 99% (95% CI, 0.97–1.00) and the recurrence rate was 1% (95% CI, 0.00–0.03). Three studies reported the complications, including perforation, bleeding and stent migration; none of the other eight studies reported complications. There were no significant differences between subgroups. There was no publication bias in either the clinical or the technical success rates. Conclusions: This meta-analysis showed that EUS-guided drainage for abdominal abscess was effective and safe, with an excellent technical success rate. In addition, EUS-guided drainage could be used for abscesses with complex anatomy. Nevertheless, complications and stent type should be considered.
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Ke X, Lin YH, Wang F. Non-surgical treatment for hematocele in the bladder associated with ascites puncture in a patient with ovarian hyperstimulation syndrome: a case report. Postgrad Med 2021; 133:112-116. [PMID: 32969742 DOI: 10.1080/00325481.2020.1827889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
Ovarian hyperstimulation syndrome (OHSS) is a well-known complication induced by the application of LH or GnRH analogs in the process of assisted reproduction controlled ovarian stimulation (COS). Ascites puncture is one of the treatments for severe OHSS. In the vast majority of circumstances, transvaginal (TV) ascites puncture under B ultrasound guidance is safe; however, bladder injury is a rare complication that may occur during the puncture process. We presented the case of a 28-year-old woman who presented with hematuria and dysuria following TV puncture for ascites aspiration for OHSS. Ultrasonographic examination revealed a 8.33 × 4.88 cm hematocele in the bladder; it was thought to have been caused by blood clot formation and concurrent urinary retention resulting from the puncture needle-induced bladder injury during TV puncture for ascites aspiration. The patient recovered with conservative treatment. Therefore, it is important to emphasize that avoidance of OHSS is necessary to avoid complications such as bladder damage from treatment of ascites.
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Affiliation(s)
- Xue Ke
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China , Chengdu, China
| | - Yong-Hong Lin
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China , Chengdu, China
| | - Fang Wang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China , Chengdu, China
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Weston M, Soyer P, Barral M, Dohan A, Pierre S, Rabei R, Garcia-Reyes K, Kohi MP. Role of Interventional Procedures in Obstetrics and Gynecology. Radiol Clin North Am 2020; 58:445-462. [PMID: 32044017 DOI: 10.1016/j.rcl.2019.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Radiological guided intervention techniques are discussed in obstetric and gynecologic patients. Fallopian tube recanalization, postpartum hemorrhage control, techniques of treating uterine leiomyomas, pelvic congestion treatment, and the use of percutaneous and transvaginal ultrasonography-guided aspirations and biopsy are covered. These techniques use basic radiological interventional skills and show how they are adapted for use in the female pelvis.
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Affiliation(s)
- Michael Weston
- Department of Radiology, St James's University Hospital, Leeds LS9 7TF, UK.
| | - Philippe Soyer
- Department of Radiology, Service de Radiologie A, Hopital Cochin, APHP & Université de Paris-Descartes Paris 5, 27 rue du Faubourg Saint-Jacques, Paris 75014, France
| | - Matthias Barral
- Department of Radiology, Service de Radiologie A, Hopital Cochin, APHP & Université de Paris-Descartes Paris 5, 27 rue du Faubourg Saint-Jacques, Paris 75014, France
| | - Anthony Dohan
- Department of Radiology, Service de Radiologie A, Hopital Cochin, APHP & Université de Paris-Descartes Paris 5, 27 rue du Faubourg Saint-Jacques, Paris 75014, France
| | - Sacha Pierre
- Department of Radiology, St James's University Hospital, Leeds LS9 7TF, UK
| | - Rana Rabei
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, M-361, San Francisco, CA 94143, USA
| | - Kirema Garcia-Reyes
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, M-361, San Francisco, CA 94143, USA
| | - Maureen P Kohi
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, M-361, San Francisco, CA 94143, USA
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Zhao N, Li Q, Cui J, Yang Z, Peng T. CT-guided special approaches of drainage for intraabdominal and pelvic abscesses: One single center's experience and review of literature. Medicine (Baltimore) 2018; 97:e12905. [PMID: 30335020 PMCID: PMC6211865 DOI: 10.1097/md.0000000000012905] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND To explore the safety and efficacy of several special approaches of drainage for deep inaccessible intraabdominal and pelvic abscesses. METHODS By searching of our institutional database, the clinical and radiologic information of all patients with special approaches of abscesses drainage was collected, consisting of etiology, diameter of abscess, duration of drainage, major complications, rates of success, failure and death, and pre-procedure, intra-procedure and post-procedure computed tomography scans. RESULTS A total of 124 patients are eligible for the criterion in our center between January 2010 and January 2018. The mean diameter of abscess was 5.6 cm (range 3.0-9.8 cm) and mean duration of drainage was 10.3 days (range 4-43 days). Pain was complained in 6 patients (4.8%) and hemorrhage was observed in one patient. Complete resolution of the abscess following drainage was observed in 115 patients (92.7%). A total of 9 patients (7.3%) failed to percutaneous abscess drainage and 3 patients died of catheter-unrelated diseases. Transintestinal afferent loop of drainage was firstly attempted in six patients and complete resolution of abscess was achieved in five patients. CONCLUSION Special approaches, including transgluteal, presacral space, transhepatic, multiplane reconstruction (MPR)-assisted oblique approach and transintestinal afferent loop approach for those deep inaccessible intraabdominal and pelvic abscesses are safe and feasible.
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Affiliation(s)
- Ning Zhao
- Department of Gastrointestinal Surgery
| | | | - Jing Cui
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiyong Yang
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Peng
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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CT-guided Drainage of Deep Pelvic Abscesses via a Percutaneous Presacral Space Approach: A Clinical Report and Review of the Literature. Acad Radiol 2016; 23:1553-1558. [PMID: 27743740 DOI: 10.1016/j.acra.2016.06.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 06/14/2016] [Accepted: 06/28/2016] [Indexed: 11/22/2022]
Abstract
RATIONALE AND OBJECTIVES Some deep pelvic abscesses are not accessible through anterior or lateral approaches because of the presence of organs and structures. The objective of this study was to assess the feasibility, safety, tolerability, and efficacy of a percutaneous presacral space approach by reviewing our clinical experience and the literature. MATERIALS AND METHODS The outcomes of 12 patients, who have undergone computed tomography (CT)-guided percutaneous presacral space drainage, were retrospectively reviewed, including demographic, clinical, and morphological data in the medical records. RESULTS From August 2010 to June 2015, 98 patients underwent CT-guided percutaneous drainage of pelvis abscesses in our institution. A percutaneous presacral space approach was adopted in 12 cases. The fluid collections were related to postoperative complications in nine patients (75%) and inflammatory or infectious intraabdominal disease in the remaining three patients (acute diverticulitis: n = 1; appendicitis: n = 1; Crohn disease: n = 1) (25%). The mean duration of drainage was 9.5 days (range 3-33). Escherichia coli was the most frequently present microorganism (in 50.0% of the all samples). No procedure-related complications were observed, either during or after the procedure. Drainage was successful in 10 patients (83.3%). Drainage failed in one patient because of massive anastomotic dehiscence. The other one died from pulmonary embolus 10 days after drainage. CONCLUSIONS When an anterior or lateral transabdominal approach is inaccessible, CT-guided transperineal presacral space approach drainage is a safe, well-tolerated, and effective procedure, except for patients with massive anastomotic dehiscence.
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Percutaneous transgluteal drainage of pelvic abscesses in interventional radiology: A safe alternative to surgery. J Visc Surg 2016; 153:3-7. [DOI: 10.1016/j.jviscsurg.2015.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Robert B, Chivot C, Fuks D, Gondry-Jouet C, Regimbeau JM, Yzet T. Percutaneous, computed tomography-guided drainage of deep pelvic abscesses via a transgluteal approach: a report on 30 cases and a review of the literature. ACTA ACUST UNITED AC 2013; 38:285-9. [PMID: 22684488 DOI: 10.1007/s00261-012-9917-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIM Percutaneous drainage of abdominal and pelvic abscesses is a first-line alternative to surgery. Anterior and lateral approaches are limited by the presence of obstacles, such as the pelvic bones, bowel, bladder, and iliac vessels. The objective of this study was to assess the feasibility, safety, tolerability, and efficacy of a percutaneous, transgluteal approach by reviewing our clinical experience and the literature. MATERIALS AND METHODS We reviewed demographic, clinical and morphological data in the medical records of 30 patients having undergone percutaneous, computed tomography (CT)-guided, transgluteal drainage. In particular, we studied the duration of catheter drainage, the types of microorganisms in biological fluid cultures, complications related to procedures and the patient's short-term treatment outcome. RESULTS From January 2005 to October 2011, 345 patients underwent CT-guided percutaneous drainage of pelvis abscesses in our institution. A transgluteal approach was adopted in 30 cases (10 women and 20 men; mean age: 52.6 [range 14-88]). The fluid collections were related to post-operative complications in 26 patients (86.7 %) and inflammatory or infectious intra-abdominal disease in the remaining 4 patients (acute diverticulitis: n = 2; appendicitis: n = 1; Crohn's disease: n = 1) (13.3 %). The mean duration of drainage was 8.7 days (range 3-33). Laboratory cultures were positive in 27 patients (90 %) and Escherichia coli was the most frequently present microorganism (in 77.8 % of the positive samples). A transpiriformis approach (n = 5) was more frequently associated with immediate procedural pain (n = 3). No major complications were observed, either during or after the transgluteal procedure. Drainage was successful in 29 patients (96.7 %). One patient died from massive, acute cerebral stroke 14 days after drainage. CONCLUSION When an anterior approach is unfeasible, transgluteal, percutaneous, CT-guided drainage is a safe, well tolerated and effective procedure. Major complications are rare. This type of drainage is an alternative to surgery for the treatment of deep pelvic abscesses (especially for post-surgical collections).
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Affiliation(s)
- Brice Robert
- Department of Digestive Radiology, Amiens North Hospital, University of Picardy, Place Victor Pauchet, 80054, Amiens Cedex 01, France.
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10
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Abstract
Since the initial studies published in the eighties, percutaneous radiologic drainage, is considered the first-line treatment of infected post-operative collections and is successful in over 80% of patients. Mortality due to undrained abscesses is estimated between 45 and 100%. Radiology-guided percutaneous drainage can be performed either with curative intent or to improve patient status prior to re-operation under better conditions. Cross-sectional imaging, using either ultrasound or computed tomography (CT), has changed the management of post-operative complications. Percutaneous drainage is most often performed by interventional radiologists and imaging is essential for road-mapping and guiding the puncture and drainage of intra-abdominal collections. Indeed, such imaging allows both identification of adjacent anatomical structures and determination of the best tract and the safest route. Cooperation between the surgeon and the interventional radiologist is essential to optimize the management and to avoid, if possible, surgery, which is so often difficult in this setting.
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Affiliation(s)
- B Robert
- Service d'imagerie médicale, département de radiologie digestive, CHU Amiens Nord, place Victor-Pauchet, 80054 Amiens cedex 01, France.
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Percutaneous image-guided aspiration versus catheter drainage of abdominal and pelvic collections. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2013. [DOI: 10.1016/j.ejrnm.2013.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ramesh J, Bang JY, Trevino J, Varadarajulu S. Comparison of outcomes between endoscopic ultrasound-guided transcolonic and transrectal drainage of abdominopelvic abscesses. J Gastroenterol Hepatol 2013; 28:620-5. [PMID: 23215873 DOI: 10.1111/jgh.12081] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Transrectal endoscopic ultrasound (EUS)-guided pelvic abscess drainage has been reported, but data on transcolonic drainage are scant. AIM To compare outcomes in patients undergoing transcolonic and transrectal drainage of abdominopelvic abscesses. METHODS Retrospective study of all patients who underwent EUS-guided drainage of abdominopelvic abscesses over a 7-year period. Abscesses were drained by a standard single-step EUS-guided technique with deployment of double-pigtail stents ± catheters. Technical success was defined as successful placement of stents or drainage catheters within the abscess cavity. Treatment success was defined as resolution of abscess on follow-up computed tomography at 2 weeks with symptom improvement. RESULTS Of 38 patients, 11 underwent transcolonic and 27 transrectal drainages. There was no difference in patient demographics, laboratory values, and median abscess size (65 vs 70 mm, P = 0.85) between the two cohorts. Etiology of abscess was postsurgical in 65.7%, diverticulitis in 13.1%, perforated viscus in 10.5%, and other causes in 10.5%. There was no difference in rates of technical success (100% in each cohort), treatment success (70% vs 96.3%, P = 0.052), or complications (none). Three patients in the transcolonic and one in the transrectal cohort underwent surgery for failed endoscopic drainage (27.3% vs 3.7%, P = 0.06). When evaluated by etiology, treatment success for diverticular abscess was significantly lower compared with others (25% vs 97%, P = 0.002). At a median follow-up of 1228.5 days (interquartile range = 131-1660), all patients with treatment success were doing well with no recurrence. CONCLUSION Except for patients with diverticular etiology, treatment of abdominopelvic abscess under EUS guidance is highly effective and safe for both routes.
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Affiliation(s)
- Jayapal Ramesh
- Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
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Sheth SS, Paghdiwalla KP, Hajari AR. Vaginal route: A gynaecological route for much more than hysterectomy. Best Pract Res Clin Obstet Gynaecol 2011; 25:115-32. [DOI: 10.1016/j.bpobgyn.2010.12.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 09/24/2010] [Accepted: 12/28/2010] [Indexed: 11/29/2022]
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Dasari BV, Lawson J, Lee J. Transrectal drainage of a diverticular abscess using a pigtail catheter without radiological guidance: a case report. J Med Case Rep 2011; 5:1. [PMID: 21205286 PMCID: PMC3022561 DOI: 10.1186/1752-1947-5-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 01/04/2011] [Indexed: 01/16/2023] Open
Abstract
Introduction Percutaneous or endocavitory drainage of a diverticular abscess under radiological guidance often enables one to perform a one-staged resection and anastomosis (without stoma formation) instead of a two-staged procedure. It reduces the significant postoperative morbidity and mortality associated with the conventional emergency surgical management. However, radiological guidance is not always available due to limited resources during out-of-hours. Case presentation A 78-year-old Caucasian woman underwent transrectal drainage of a diverticular abscess performed with a pigtail catheter without radiological guidance. Technical details of the procedure are described and alternative options discussed. Conclusion In carefully selected patients, per-rectal drainage using a pigtail catheter can be performed without radiological guidance and the procedure offers a simple and effective way of controlling sepsis.
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Affiliation(s)
- Bobby Vm Dasari
- Level 2, Department of General Surgery, Belfast City Hospital, Belfast, BT9 7AB, UK.
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Napolitano R, Sansone M, Floridia M, Cappelli C, Maruotti GM, Agangi A, Capone A, Mazzarelli LL, Martinelli P. Prevalence and characteristics of symptomatic and asymptomatic tuboovarian masses in women with HIV: an ultrasonographic study. Int J STD AIDS 2010; 21:472-6. [PMID: 20852196 DOI: 10.1258/ijsa.2009.009223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
HIV-positive women with pelvic inflammatory disease have been reported to have an increased prevalence of tuboovarian masses (TOMs). The aim of this study was to assess the prevalence of asymptomatic ultrasonographic TOMs in women with HIV and to identify associated factors in order to formulate a selective ultrasonographic screening strategy. Two-hundred and four HIV outpatients underwent transvaginal ultrasonography. Eight (3.9%) had a diagnosis of TOM (5 were asymptomatic). Two profiles of patients at risk for TOM were identified who could be considered for selective screening strategies: the 'long-term infected' (age>35 years, diagnosis of HIV infection more than 5 years ago, HIV clinical category C, CD4 counts below 200/mm(3), >5 lifetime partners and on antiretroviral therapy) and the 'recently diagnosed with HIV' (African ethnicity, age 25-35, HIV diagnosis in the previous year, >5 lifetime partners, HIV clinical category C and not on antiretroviral therapy).
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Affiliation(s)
- R Napolitano
- Department of Obstetrics and Gynecology, Centre for STD and HIV/AIDS in Obstetrics and Gynecology, University of Naples, Federico II, Italy
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Varadarajulu S, Lee YT. EUS 2008 Working Group document: evaluation of EUS-guided drainage of pelvic-fluid collections (with video). Gastrointest Endosc 2009; 69:S32-6. [PMID: 19179167 DOI: 10.1016/j.gie.2008.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Accepted: 11/03/2008] [Indexed: 12/10/2022]
Affiliation(s)
- Shyam Varadarajulu
- Division of Gastroenterology-Hepatology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama 35294, USA
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Endoscopic transcolonic catheter-free pelvic abscess drainage. CANADIAN JOURNAL OF GASTROENTEROLOGY = JOURNAL CANADIEN DE GASTROENTEROLOGIE 2008; 22:983-6. [PMID: 19096737 DOI: 10.1155/2008/848737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Natural orifice transluminal endoscopic surgery is a novel therapeutic method in development that uses different routes of surgical approach. The use of various methods, instruments and accessories during this procedure are currently being investigated. A case of appendicitis-related intra-abdominal abscess that was resolved by a transcolonic endoscopic approach using a wide-channel colonoscope with the help of precut and standard sphincterotome without radiological percutaneous drainage is presented.
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Garcia RG, Macedo Filho CLD, Maurano A, Francisco Neto MJ, Daniel MM, Rosemberg LA, Funari MBDG. Procedimentos percutâneos pélvicos guiados por imagem: revisão das principais vias de acesso. Radiol Bras 2008. [DOI: 10.1590/s0100-39842008000500014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Os procedimentos percutâneos orientados por imagem têm ganhado espaço crescente na radiologia intervencionista, constituindo ferramenta eficaz para a abordagem diagnóstica e terapêutica de massas e coleções nos diversos segmentos corporais. No entanto, localizações pélvicas profundas ainda representam grande desafio para o radiologista, por causa da interposição de estruturas anatômicas. Para que o procedimento seja bem sucedido é fundamental o planejamento da via de acesso baseado no conhecimento detalhado da anatomia radiológica da pelve. As principais vias de acesso para a abordagem destas lesões são: transabdominais (anterior e lateral), extraperitoneal ântero-lateral, transvaginal, transretal e transglútea. O objetivo deste trabalho é fazer uma revisão da anatomia seccional pélvica normal, demonstrando as diversas vias de acesso para biópsias e drenagens guiadas pela ultra-sonografia e pela tomografia computadorizada, bem como discutir as principais vantagens e complicações potenciais de cada uma delas.
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Bonnel DH, Cornud FE, Liguory CL, Lefebvre JF, Dazza FE. [Image guided drainage of pelvic fluid collections: results in 42 patients]. ACTA ACUST UNITED AC 2005; 86:61-8. [PMID: 15785418 DOI: 10.1016/s0221-0363(05)81323-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To review the etiology, location, and morphology of pelvic collection as well as the technique and results of image guided drainage. MATERIALS AND METHODS From June 1996 to August 2002, we performed image guided drainage of pelvic fluid collections in 21 males and 21 females. In patients where a direct contact between the collection and the endocavitary probe was present, the drainage was performed either by transrectal or transvaginal approach using 10F, 12F, 14F or 16F catheters according to the viscosity of the fluid. When the patients were no longer septic, when drainage had stopped, the drains were removed at day 5. When a fistula was present, the drain was left in place until the fistula healed. RESULTS The most common location of pelvic collections was the cul-desac (43%). A total of 81% of pelvic abscesses were digestive in origin, either from the colon or appendix. Transrectal or transvaginal drainage was possible in 83% of cases. Mean follow-up was 41 months. No drainage related complication was recorded. In two patients with collections of clear fluid, a simple aspiration was performed without insertion of a drain. In the 40 other patients, a drainage catheter was inserted. Twenty-nine patients were cured after 15 days of drainage. Two patients had recurrent collections. Image guided drainage failed in five patients, and all underwent successful surgical management. CONCLUSION Image guided drainage of pelvic collections is a safe and effective procedure. Failures were due to initially undiagnosed pathology requiring surgical treatment.
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Affiliation(s)
- D H Bonnel
- Centre d'imagerie Tourville, 19 avenue de Tourville, Paris 75007, France
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Créquat J, Teboul-Faure L, Fortin A, Batallan A, Madelenat P. [Endorectal sonography in gynecology: usefulness and diagnostic accuracy]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2004; 32:950-3. [PMID: 15567683 DOI: 10.1016/j.gyobfe.2004.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2004] [Accepted: 09/20/2004] [Indexed: 05/01/2023]
Abstract
OBJECTIVE The aim of this study was to assess feasibility and diagnostic accuracy of endorectal sonography (ERS) in comparison with transabdominal sonography (TAS) in women with a contraindication to endovaginal sonography (EVS). PATIENTS AND METHODS ERS was proposed to 32 patients in the immediate continuation of TAS. It was performed either with a specific probe or with a vaginal probe. The protocol included a complete evaluation of pelvic structures observed with both sonographic techniques. RESULTS After counselling and assent, 29 of the 32 patients (90%) accepted ERS. The examination was regarded as complete in 28 cases. ERS confirmed the absence of pelvic anomaly in the 12 cases of normal TAS. ERS modified diagnosis in 5 of the 8 cases of anechoic ovarian cysts seen in TAS. In 4 cases, PCOs not seen in TAS were identified. Two partially sub-mucous myomas not recognized by TAS were diagnosed by ERS. Sensibility, specificity, positive predictive value (PPV) and negative predictive value (NPV) of TAS and ERS were 38,4 and 87,5%, 41,6 and 100%, 50 and 100%, 40 and 85,7% respectively. DISCUSSION AND CONCLUSION These findings suggest ERS is an effective diagnostic tool in pelvic exploration when EVS cannot be performed. It should be widely proposed after information and assent.
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Affiliation(s)
- J Créquat
- Service de gynécologie-obstétrique, hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75877 Paris 18, France.
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Abstract
The interventionist can perform many emergent procedures with ultrasound guidance, because of its real-time, multiplanar imaging capability and portability. With the use of color Doppler, additional important information, such as aberrant vessels, can be ascertained to help plan needle trajectory. Ultrasound is also useful for nonemergent procedures, such as biopsies. All interventionists are encouraged to be facile with the use of ultrasound.
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Affiliation(s)
- Dean A Nakamoto
- Department of Radiology, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
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