ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2022
vol. 87
 
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Interventional radiology
abstract:
Case report

Cranio-caudal puncture with computed tomography-guided drainage of a deep pelvic abscess

Takuya Mori
1
,
Hidenori Mitani
2
,
Keigo Chosa
2
,
Wataru Fukumoto
2
,
Yasutaka Baba
3
,
Kazuo Awai
2

1.
Department of Diagnostic Radiology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima City, Japan
2.
Department of Diagnostic Radiology, Hiroshima University Hospital, Hiroshima City, Japan
3.
Department of Diagnostic Radiology, Saitama Medical University, International Medical Centre, Hidaka City, Japan
Pol J Radiol 2022; 87: e177-e180
Online publish date: 2022/03/17
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Purpose
Computed tomography (CT)-guided percutaneous drainage has been used to address pelvic abscesses because it is safe and minimally invasive. However, CT-guided drainage has the limitation that the puncture route should be on the same axial slice. A technique for puncturing in the cranio-caudal direction under CT fluoroscopy is needed.

Case report
An 82-year-old man with an abscess due to rectal cancer was scheduled for CT-guided drainage to improve his general condition before radical surgery. Drainage was performed via a perineal approach to localize the drainage tract in the resection area to avoid dissemination of cancer cells. To perform a puncture in the cranio-caudal direction we controlled the needle like a joystick and advanced it under CT fluoroscopy while moving the CT gantry cranially to follow the needle tip throughout the puncture. Our unique technique yielded successful CT-guided puncture in the cranio-caudal direction.

Conclusions
Our unique technique overcomes the limitations of CT-guided cranio-caudal puncture and may allow the drainage of abscesses whose treatment was heretofore difficult.

keywords:

CT guided drainage, puncture, unique drainage technique




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