Use of the Transrectal Ultrasound Probe in Aspiration and Drainage in Pediatric Patients: A Retrospective Observational Study

Image-Guided Transrectal Drainage of Pelvic Abscesses in Children

“…The most common causes of pelvic abscesses in children are perforated appendicitis, postoperative collections (mostly laparoscopic appendectomy), and inflammatory bowel disease. [3][4][5][6] Approximately 30% of children with appendicitis have evidence of perforation. 7 There is no standard treatment for perforated appendicitis, with or without abscess formation.…”

“…10 However, in the presence of intra-abdominal infection, antibiotics alone are often insufficient in treating and developing intra-abdominal abscesses, with up to 86% eventually requiring percutaneous drainage. 7 Image-guided percutaneous drainage of intra-abdominal abscesses is a well-established treatment option instead of surgery, 3,4,11 but the risk of injury to the bowel, bladder, uterus, or major vessels can make it not feasible in some cases. [12][13][14] Under these circumstances, image-guided TRD of deep pelvic abscesses is the preferred approach, 8,9 and it is the standard of care in our institution.…”

“…More recently, endocavitary (transrectal, transvaginal) probes with needle-guide attachment have been successfully used to localize and access deep pelvic abscesses. 2,3,6,12,13 Previous studies have reported on the safety and efficacy of TRD in children as young as 2 years old. 3 Like the experience reported by Mubarak et al, overall, we generally found the transrectal probe with needle-guide attachment to be easy to use in most patients, including those as young as 3 years old.…”

“…2,3,6,12,13 Previous studies have reported on the safety and efficacy of TRD in children as young as 2 years old. 3 Like the experience reported by Mubarak et al, overall, we generally found the transrectal probe with needle-guide attachment to be easy to use in most patients, including those as young as 3 years old. Transabdominal sonography was used in 6 out of our 68 patients (8.8%), usually due to the young age of the patient and excellent visualization of the deep pelvic collection.…”

“…Previous reports have demonstrated the safety and effectiveness of ultrasound and fluoroscopyguided TRD techniques for managing pelvic collections in children. [1][2][3] Indications for TRD in children include patients with suspected infected pelvic collections that cannot be safely accessed with a percutaneous transabdominal approach. TRD of pelvic abscesses can be used to provide source control, symptomatic pain relief, reduce compression on adjacent structures, relieve associated bowel obstruction, and obtain fluid samples for microbiologic studies.…”