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Pediatric Radiology

, Volume 45, Issue 1, pp 94–98 | Cite as

Transiliopsoas approach: an alternative route to drain pelvic abscesses in children

  • Samuel E. BorofskyEmail author
  • Chrystal Obi
  • Anne Marie Cahill
  • Adeka McIntosh
  • Marian Gaballah
  • Marc S. Keller
Original Article
  • 229 Downloads

Abstract

Objective

To evaluate an alternative route of pelvic abscess drainage in children via a transiliopsoas approach.

Background

Appendiceal perforations complicated by inflammatory masses, such as abscesses or phlegmon, are a common indication for abdominal drainage in pediatric interventional radiology. Certain locations of collections may present particular challenges for the operator, owing to numerous surrounding structures, including bowel and other pelvic anatomy. This series describes an alternative route for drainage, which involves traversing the iliopsoas muscle under US guidance to drain a deep pelvic abscess.

Materials and methods

Retrospective chart review was performed of the transiliopsoas approach for abscess drainage during a 5-year period. The technique, pre- and post-drainage imaging, aspiration/drain output, duration of catheter dwell, procedure-related complications and abscess recurrence were reviewed.

Results

Transiliopsoas needle placement was successful in 14 of 14 patients (100%). Catheter placement was successful in 13 patients. Abscess wall rupture precluded catheter placement in one patient. Mean catheter duration was 4.9 days, with a range of 2 to 9 days. Clinical improvement was achieved in all 14 patients (100%). There were no major complications. Post-procedure pain with ambulation was reported in 3 of 14 patients (21.4%), which was successfully controlled in each case with medication, and resolved after 2 days.

Conclusion

The transiliopsoas route is a safe and effective route for US-guided abscess drainage and catheter placement in children with deep pelvic collections. In selected cases, this approach provides a more easily accessible and safer route than more traditional interventional approaches.

Keywords

Children Ultrasound Transiliopsoas Iliopsoas Abscess Percutaneous drainage Appendicitis 

Notes

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Samuel E. Borofsky
    • 1
    Email author
  • Chrystal Obi
    • 1
  • Anne Marie Cahill
    • 1
  • Adeka McIntosh
    • 1
  • Marian Gaballah
    • 1
  • Marc S. Keller
    • 1
  1. 1.Department of Interventional RadiologyThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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