EUS 2008 Working Group document: evaluation of EUS-guided drainage of pelvic-fluid collections (with video)

摘要

Pelvic-fluid collections or abscesses often present a clinical challenge because of their location: surrounded by the bony pelvis, bladder, bowel, uterus, vagina, prostrate, rectum, and other neurovascular structures. These collections may occur as a common complication of surgery and medical diseases. An anastomotic leak after large-bowel resection, particularly low anterior resection, is the most common surgical cause and may occur in 0.5% to 30% of cases. Diverticulitis, ischemic colitis, Crohn's disease, appendicitis, and sexually transmitted diseases are other etiologies. Because US often fails to detect deep or multi-focal collections, the best diagnostic modality for patients suspected to have pelvic-fluid collections is a CT of the abdomen and pelvis. The CT findings, in combination with the patient's clinical status, determine the most appropriate mode of treatment. This section of the EUS 2008 Working Group Proceedings evaluates the current evidence and potential role of EUS in the management of patients with pelvic-fluid collections that encompasses abscesses.