EUS-Guided Drainage of Pelvic Abscesses

Abstract

Deciding how to treat pelvic abscesses can pose a clinical dilemma. They usually occur after surgery or in patients with medical conditions such as Crohn’s disease, diverticulitis, ischemic colitis, sexually transmitted diseases, or septic emboli from endocarditis. However, the anatomical challenges make this a clinical obstacle, with navigation needed around the bony pelvis, bladder, bowel, reproductive organs in females, the prostate in men, rectum, and other neurovascular structures. Historically, pelvic abscesses necessitated surgery and ultrasound-guided transrectal or transvaginal interventions or were percutaneously drained under computed tomography (CT) guidance. Recently, there have been advances in the field of interventional endosonography that have opened a new avenue for drainage. This chapter will review the different treatment options for draining pelvic abscesses, with a focus on the technique of endoscopic ultrasound (EUS)-guide drainage.