Endoscopic transrectal drainage of a diverticular abscess☆,☆☆,★
Section snippets
CASE REPORT
A 59-year-old man was initially admitted with a massive anterior wall myocardial infarction and cardiogenic shock. Five days after admission, he developed lower abdominal and back pain with progressive leukocytosis. CT of the abdomen revealed free air, sigmoid diverticula, and an inflammatory mass consistent with diverticulitis. Medical management with intravenous antibiotics and total parenteral nutrition resulted in clinical improvement, but leukocytosis and lower abdominal pain persisted.
DISCUSSION
Deep pelvic abscesses such as those arising from diverticulitis or appendicitis have been treated by operative transrectal incision and drainage as early as 1939 by Oschner and Murray. 1 Although variations on the surgical technique and types of drains have been described by others,2, 3, 4 transrectal drainage of pelvic abscesses has been underutilized, 5 and no prospective data exist on its complication or recurrence rates. In the radiologic literature, much has been written on the
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Cited by (13)
Diverticular abscess successfully treated by endoscopic transluminal drainage
2014, Clinics and Research in Hepatology and GastroenterologyEndoscopic transduodenal drainage of the gallbladder: implications for endoluminal treatment of gallbladder disease
2007, Gastrointestinal EndoscopyCitation Excerpt :Endoscopic transpapillary gallbladder drainage has been described for management of cholecystitis and symptomatic cholelithiasis.3,5 Transmural entry and drainage of pancreatic fluid collections6 and transmural drainage of a variety of other periluminal fluid collections7-10 have been described, although internal drainage of the gallbladder using a transmural approach has not. We believe this case was successful because, under EUS guidance, the puncture was intentionally directed into the neck of the gallbladder.
Endoscopic transgastric drainage of a subphrenic abscess
2007, Gastrointestinal EndoscopyCitation Excerpt :Endoscopic transmural drainage of pancreatic-fluid collections, including abscesses, is well described.1-3 Transluminal drainage of pelvic abscesses, retroperitoneal lymphoceles, and a postappendectomy abscess has, likewise, been described.4-7 This is the first case report, to the author's knowledge, of the endoscopic transgastric drainage of an intra-abdominal abscess related to a bile leak.
EUS-guided drainage of a diverticular abscess as an adjunct to surgical therapy
2003, Gastrointestinal EndoscopyTransmural drainage of pancreatic fluid collections without electrocautery using the Seldinger technique
1998, Gastrointestinal EndoscopyEndoscopic transgastric drainage of a retroperitoneal lymphocele
1998, Gastrointestinal Endoscopy
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From the Department of Medicine, Division of Gastroenterology & Hepatology, and the Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama.
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Reprint requests: Todd H. Baron, MD, Gastroenterology & Hepatology, 633 ZRB, University of Alabama at Birmingham, Birmingham, AL 35294–0007.
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