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Figure 1b. Prone transverse CT scans in a 15-year-old female patient with a pelvic abscess in the pouch of Douglas after perforating appendicitis. (a) Purulent fluid was aspirated through the transgluteal sheathed access needle (Yueh; Cook, Bloomington, Ill). The stylet was removed from the needle (short arrow) and a guidewire (long arrow) advanced into the collection. Layering gastrointestinal contrast material (*) remains evident in dependent portions of rectum and bowel loops. (b) Scan obtained after the tract was dilated to 9 F and an 8.5-F locking pigtail drainage catheter advanced into the collection over a metal stiffener. The stiffener and guidewire were removed and the catheter (arrow) was locked and fixed to the skin. The cavity was aspirated and the catheter left to gravity drainage. Layering gastrointestinal contrast material (*) remains evident in dependent portions of rectum and bowel loops.
