EUS- guided trans-rectal drainage of intrapelvic abscess collections – two case reports

Intraabdominal and intrapelvic abscess collections can become a serious clinical issue that in some cases require invasive treatment. Endoscopic ultrasound (EUS)- guided drainage techniques are widely used in peripancreatic fluid collections and are more often used in other indications, being a safe and efficient method that is less invasive than surgery.

Two patients were treated with EUS- guided, trans-rectal drainage of intrapelvic and intraabdominal abscess collections. The first patient developed several abscess collections (up to 107 x 60 mm) in abdomen and pelvis after palliative surgery for disseminated pancreatic cancer. The second patient developed two intrapelvic abscess collections (45 x 72 x 39mm and 16 x 19 x 35 mm) in course of diverticular disease. Both patients were treated by an experienced EUS operator with 80-100 therapeutic EUS per year. In both cases we used single-operator, one-step cystotome+lumen apposing metal stent (LAMS) device. There was only one stent implanted in each case. The procedures lasted several minutes each and both were technically successful. In following days we observed almost complete regression of abscess collections and clinical symptoms of inflammation. There were no adverse events in 3 months+follow- up [1] [2].

EUS-guided drainage techniques offer a safe and efficient method of treating various fluid collections. For the time being there are very few reports available of this method being used in other indication than peripancreatic fluid collections and transmural biliary drainage. Our experiences show that further indications should be pursued in high-volume expert centers.

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Artikel online veröffentlicht:
27. März 2025

• References

• 1 Donatelli G, Cereatti F, Fazi M, Ceci V, Dhumane P.. Endoscopic ultrasound-guided drainage of intra-abdominal diverticular abscess. A case series. J Minim Access Surg 2021; 17 (4) 513-518
• 2 Drnovšek J, Čebron Ž, Grosek J, Janež J.. Endoscopic ultrasound-guided transrectal drainage of a pelvic abscess after Hinchey II sigmoid colon diverticulitis: A case report. World J Clin Cases 2023; 11 (12) 2848-2854