Division of Interventional Radiology, Boston Children's Hospital, Boston, Massachusetts, United States.
Eur J Pediatr Surg. 2024 Oct;34(5):464-469. doi: 10.1055/s-0044-1779278. Epub 2024 Feb 6.
To describe our technique and share our experience with image-guided transrectal drainage (TRD) of pelvic abscesses in children.
Retrospective review and analysis of indications for image-guided TRD and examination of procedural outcomes in pediatric patients with pelvic abscesses over 8 years.
A total of 69 patients (33 males and 36 females) with symptomatic pelvic abscesses underwent image-guided TRD. The median age and weight of the patients were 11.5 years (range, 3-18) and 46.8 kg (range, 15.1-118.0), respectively. The etiologies of the pelvic abscesses were perforated appendicitis (72.5%) and post-operative collections (27.5%). All patients presented with abdominal pain. Fever, emesis, and diarrhea were also common symptoms. The size of the pelvic abscesses ranged from 24.0 to 937.1 mL (median, 132.7). Technical success was achieved in 68 of 69 TRD procedures (98.6%). Clinical improvement was observed in all patients with technically successful TRD. The TRD catheter dwell time ranged from 0 to 10 days (median, 4.0). Most patients who underwent TRD for perforated appendicitis subsequently underwent elective appendectomy after the resolution of the pelvic abscess (84.0%). The median time from TRD to elective appendectomy was 2.8 months (range, 0.3-6.1). There were no procedure-related complications.
Image-guided TRD is a safe and effective procedure with high technical and clinical success rates for the treatment of pelvic abscesses in children.
描述我们应用影像引导经直肠引流（TRD）治疗儿童盆腔脓肿的技术，并分享我们的经验。
回顾性分析 8 年来因盆腔脓肿行影像引导 TRD 的患儿的适应证，并对其操作结果进行检查。
共有 69 例（33 例男性，36 例女性）有症状的盆腔脓肿患儿接受了影像引导 TRD。患儿的中位年龄和体重分别为 11.5 岁（范围，3-18 岁）和 46.8kg（范围，15.1-118.0kg）。盆腔脓肿的病因包括穿孔性阑尾炎（72.5%）和术后脓肿（27.5%）。所有患儿均表现为腹痛，发热、呕吐和腹泻也是常见症状。盆腔脓肿的大小范围为 24.0 至 937.1mL（中位数，132.7mL）。69 例 TRD 操作中，技术成功 68 例（98.6%）。技术成功的 TRD 患儿均获得临床改善。TRD 导管留置时间为 0 至 10 天（中位数，4.0 天）。大多数因穿孔性阑尾炎而行 TRD 的患儿在盆腔脓肿消退后接受择期阑尾切除术（84.0%）。TRD 至择期阑尾切除术的中位时间为 2.8 个月（范围，0.3-6.1 个月）。无手术相关并发症。
影像引导 TRD 是一种安全有效的治疗儿童盆腔脓肿的方法，具有较高的技术和临床成功率。
