Murai Kazuki, Kageyama Ken, Yamamoto Akira, Nakano Mariko, Jogo Atsushi, Miki Yukio
Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan.
Radiol Case Rep. 2024 Mar 6;19(5):2081-2084. doi: 10.1016/j.radcr.2024.02.040. eCollection 2024 May.
A 52-year-old male patient presented with complaints of abdominal and back pain. CT revealed a deep pelvic abscess extending into the anterior sacral space. Since puncture via the conventional transgluteal approach cannot reach a deep abscess, percutaneous pelvic abscess drainage was performed under CT fluoroscopy using the cranio-caudal puncture technique. The cranio-caudal puncture requires needle insertion perpendicular to the CT cross-section. This method advances the CT gantry deeper than the needle tip and follows the CT cross-section with the needle tip. This series of images and movements continues until the needle reaches the target. The procedure was successful without complications, the abscess was reduced in size, and blood test data improved. The cranio-caudal puncture technique provides an alternative for the drainage of deep pelvic abscesses that avoids the complications associated with gluteal muscle puncture. Percutaneous drainage of pelvic abscesses under CT fluoroscopy-guided cranio-caudal puncture offers a safe option as a puncture route for deep pelvic abscesses.
一名52岁男性患者主诉腹痛和背痛。CT显示盆腔深部脓肿延伸至骶前间隙。由于经传统经臀入路穿刺无法到达深部脓肿，遂在CT透视引导下采用头-尾穿刺技术进行经皮盆腔脓肿引流。头-尾穿刺要求针垂直于CT横截面插入。该方法使CT扫描架比针尖更深入，并使针尖沿着CT横截面移动。这一系列图像和动作持续进行，直到针到达目标位置。该操作成功，无并发症发生，脓肿体积缩小，血液检测数据改善。头-尾穿刺技术为深部盆腔脓肿引流提供了一种替代方法，避免了与臀肌穿刺相关的并发症。CT透视引导下头-尾穿刺经皮引流盆腔脓肿为深部盆腔脓肿提供了一种安全的穿刺途径选择。
