PELVIC FLUID COLLECTIONS - ANATOMY FOR INTERVENTIONAL PROCEDURES

The use of imaging-guided percutaneous interventional procedures has become routine over the last 10 years. During the early experience with imaging-guided intervention, biopsies and drainages of many pelvic lesions were considered inappropriate for percutaneous procedures. This was often due to a lack of a safe access route.(1) Anteriorly, bowel and bladder limit access to deep pelvic lesions. Posteriorly and laterally, the bony elements of the pelvis prevent easy access to pelvic lesions.(2) With advances both in imaging and interventional techniques, many of these previously ''unreachable'' lesions can now be safely accessed. Knowledge of the imaging characteristics of pelvic lesions and of pelvic anatomy is essential for proper planning of an interventional procedure.(3) This chapter will discuss pelvic anatomy relevant to performing percutaneous procedures, specifically biopsies and abscess drainages, along with specific anatomic considerations for various approaches to lesions in the pelvis.