Pelvic Abscess Percutaneous Drainage in Begusarai:The Procedure, Benefits & More

An abnormal buildup of inflammatory fluid called pus (a yellowish-white fluid consisting of white blood cells, microorganisms, and dead tissues) is an abscess that can occur anywhere in your body. An abscess in the female pelvis is called a pelvic abscess, with men rarely affected by it. When your body is inflicted with an infection, an inflammatory response occurs as a defense mechanism to fight off the infection. This results in the accumulation of pus within a confined area (pocket or sac) which may cause pain and discomfort. A pelvic abscess can be managed through non-surgical and several surgical methods depending on the size and severity of the condition. But abscess drainage remains the most classical method of treatment, which is safe and effective. One such drainage method discussed further in the article is percutaneous drainage of the pelvic abscess. So, read on!

Management of a pelvic abscess depends on the size, extent of the abscess, and severity of the symptoms. A pelvic abscess, when small and in an early stage, can be managed through antibiotics alone, which are determined based on the blood culture reports ( a type of blood analysis that checks for the growth of organisms to determine the type of antibiotics that would best work to fight the infection). 

However, percutaneous drainage is the standard treatment of choice when a large pelvic abscess presents with severe abdominal pain and discomfort, negatively affecting your quality of life. It is also recommended when there is no indication for emergency surgery.

Pelvic abscess percutaneous drainage is the standard and first-line treatment for infected and symptomatic (when symptoms are severe) pelvic abscesses. It is typically performed without indications for immediate or emergency surgery. It is a relatively non-invasive procedure (does not involve trauma to the surrounding structures, incisions, or cuts) performed under image guidance through ultrasound or CT (Computed Tomography) scan. Percutaneous means "through the skin," where a thin needle is inserted into the abscess to collect the pus sample, and later a catheter (a thin, flexible tube) is placed for several days to drain the pus.

Percutaneous drainage is an image-guided procedure performed by a specially trained interventional radiologist. 

• You will lie flat on the procedure table with only the area for placing the catheter, which will be exposed and disinfected.
• Your nurse will connect monitors to track your vitals like BP (blood pressure), pulse, heart rate, and oxygen level.
• An IV (intravenous) line is inserted through your vein to administer the anesthetic solution to sedate you. 
• The procedure will begin by inserting a thin needle through a small nick at the site.
• Your radiologist will use image guidance through ultrasound or CT scan and place a catheter through the skin into the pelvic abscess. This helps in the abscess drainage and will be placed until your infection is gone. 
• This procedure is usually completed in 20 minutes to 1 hour.

Percutaneous drainage of the pelvic abscesses is a safe and non-invasive procedure that may require you to stay overnight in the hospital, so you must make arrangements accordingly. It is important to be well prepared before the procedure for a successful outcome and speedy recovery by following guidelines:

• Women patients must inform the surgeon if they are pregnant so that necessary precautions can be taken during certain investigations like X-rays (if required). 
• You must cooperate with your healthcare team during diagnostic tests like blood analysis, ultrasound, CT, or MRI (Magnetic Resonance Imaging) scans. These tests help to check infections and determine the size and exact location of the pelvic abscess.
• Make sure to inform your surgeon about your medical history, like diabetes (increased blood sugar levels), hypertension (high blood pressure), drug allergies (especially to anesthesia), etc, to avoid complications during or after the procedure. 
• List the medications to your surgeon, including herbal and vitamin supplements, and discuss what medicines must be discontinued before the procedure. You may be asked to stop blood thinners and aspirin at least 2 weeks before the procedure.
• You may be asked not to eat or drink several hours before the drainage procedure.

A pelvic abscess is the collection of pus within a defined wall (sac) of inflammatory tissue. These are usually uncommon abscesses but, when occurring, may cause lower abdominal pain, fever, presence of pelvic mass, vaginal bleeding or discharge, fatigue (weakness), nausea, vomiting, diarrhea (frequent loose stools), and frequent urination. 

A pelvic abscess may typically occur in females in the pouch of Douglas, fallopian tube, and ovaries following lower abdominal surgeries. It can develop as a complication of appendicitis (inflammation of the appendix), pelvic inflammatory disease (PID), or lower genital tract infections.

You will remain in the recovery room for 1 to 2 hours, with your vitals monitored continuously until you are awake and ready to be shifted to your hospital bed. 

• You will be required to stay in the hospital, depending on your progress. 
• Regular follow-ups will be done on an outpatient basis where your Interventional radiologist will monitor if your healing process is proceeding according to the plan.
• You may be prescribed pain relief medications and antibiotics depending on the severity of your condition.
• Once your surgeon and radiologist are satisfied that healing is complete, the catheter is removed.
• Recovery is quick and takes around 2 weeks (approximately).

Image-guided percutaneous pelvic abscess drainage is a safe and non-invasive procedure with the following benefits. 

Benefits 

• There are no surgical incisions (cuts) required. 
• Healing is quick, with a short recovery time.
• There is no visible scarring since it does not involve any incisions or stitches.
• There are little to no postoperative precautions to be taken.

Risks 

As with any medical procedure, percutaneous drainage of a pelvic abscess also has some associated risks:

• Risk of infection
• Slight risk of allergic reaction to the anesthesia that may cause hives, rash, dizziness, confusion, and shortness of breath.
• There could be occasional bleeding around the catheter being placed.
• There could be displacement or blockage of the catheter that may require adjustment or change.

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