Endoscopic Ultrasound-Guided Pelvic Abscess Drainage Especially for Pediatric Patients: A Report of Two Cases.

Abstract

Introduction: Endoscopic ultrasound-guided pelvic abscess drainage (EUS-PAD) was reported for the first time in 2003. However, there were few reports focused on EUS-PAD in pediatric patients beforehand. This procedure is one of the minimally invasive methods of treating pelvic abscess, which is close to the rectum. Here, we report the cases of two pediatric patients who underwent EUS-PAD.

Case presentation: Two pediatric patients were referred to our hospital for the treatment of pelvic abscesses associated with appendicitis. Using endoscopic ultrasound (EUS) guidance, a pelvic abscess was identified adjacent to the rectal wall. After successive dilatation through a guidewire during fluoroscopic imaging, the deployment of one or two double pigtail stents was performed. Following successful stent deployment, both patients experienced good courses without any complications. After addressing the consequences of complicated appendicitis, both patients underwent laparoscopic appendectomy, which resulted in favorable postoperative courses.

Conclusions: EUS-guided drainage can be considered a safe and effective method for primarily dealing with pelvic abscesses and as an efficacious bridge-to-surgery strategy for pediatric patients.