Pelvic abscess drainage: outcome with factors affecting the clinical success.

Akıncı D, Ergun O, Topel Ç, Çiftçi T, Akhan O
Diagnostic and interventional radiology (Ankara, Turkey) · 2018 · doi:10.5152/dir.2018.16500 · PMID:29770767 · PMC5951203
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This study evaluated the clinical success and complication rates of image-guided pelvic abscess drainage in 163 patients over a seven-year period. Researchers analyzed various factors including etiology, access route, and abs characteristics to determine their impact on treatment outcomes and catheter duration. The results demonstrated a high technical and clinical success rate with no major complications, identifying fistulization as the primary factor negatively affecting clinical success. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

PurposeWe aimed to evaluate the success and complication rates of image-guided pelvic abscess drainage with emphasis on factors affecting the clinical success.MethodsDuring 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.ResultsTechnical 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).ConclusionImage-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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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

İmage-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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