Case Report

High presacral collection approached through the perineal route: A novel computed tomography-guided technique

Shuchi Bhatt, Harsit Bansal, Sagar Nayak, Saumya Dangwal
South African Journal of Radiology | Vol 25, No 1 | a2014 | DOI: https://doi.org/10.4102/sajr.v25i1.2014 | © 2021 Shuchi Bhatt, Harshit Bansal, Sagar Nayak, Saumya Dangwal | This work is licensed under CC Attribution 4.0
Submitted: 15 October 2020 | Published: 11 March 2021

About the author(s)

Shuchi Bhatt, Department of Radiodiagnosis, Faculty of Health Sciences, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi, India
Harsit Bansal, Department of Radiodiagnosis, Faculty of Health Sciences, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi, India
Sagar Nayak, Department of Radiodiagnosis, Faculty of Health Sciences, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi, India
Saumya Dangwal, Department of Orthopaedics, Faculty of Health Sciences, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi, India


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Abstract

For a definitive diagnosis of abdomino-pelvic lesions, percutaneous aspiration or biopsy is often necessary; however, finding a safe ‘window’ for access is challenging. This case report discusses a novel method to approach a deep pelvic collection and also briefly reviews the various approaches to access such lesions. A sample was obtained from a non-resolving presacral collection using a CT-guided percutaneous, trans-perineal approach with repeated sessions of hydro-dissection. Successful aspiration and analysis revealed multi-drug resistant tuberculosis, thus guiding appropriate management.

Keywords

MDR; TB; infectious medicine; interventional radiology; trans-perineal

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