A vaginal drain of a pelvic abscess due to colonic diverticulitis

Abstract

Although well recognized for tubo-ovarian abscesses, we report, in our best knowledge, the first case of a vaginal drain of a pelvic abscess due to colonic diverticulitis. A 78-year-old patient presented with abdominal and pelvic pain, fever (39.3 °C) and an elevated white blood cell count (18500/mL). After abdominopelvic computed tomography the patient was presumed to have a pelvic abscess, which developed as a complication of the sigmoid diverticulitis. Due to the numerous intervening structures that create obstacles to safe percutaneous access, we planned a trans-vaginal drain. A rapid recovery was obtained within 2 d from the procedure and, at present, the follow-up was uneventful after 18 mo. We believe that transvaginal drain of pelvic abscess could be a useful alternative, when percutaneous approach is not feasible.

Keywords: Vaginal, Drain, Diverticulitis, Pelvic abscess, Echography

Core tip: Large diverticular abscesses (> 3 cm) should be treated by antibiotics and percutaneous drain. Abscess deep in the pelvis pose a unique problem because numerous intervening structures create obstacles to safe percutaneous access. Transvaginal drain of pelvic abscess could be an useful alternative, when percutaneous approach is not feasible.