Deep pelvic collections are a challenge to interventional radiologist. This anatomical location has a difficult approach with high risk of damaging vulnerable structures, such as bladder, colon, prostate, uterus, ovarian and vessels.

Poor ultrasound visualization is typical, especially in anterior or lateral approach, secondary to interposition of intestinal loops. In this situation, the role of CT to guide puncture have been improve for the development of new tools, such as my needle guide or fusion 3D/3D, which do the procedure more secure, fast and efficacy (1,2).

The echography should be the first option where possible in cases where the collection is located close to the rectum or vagina, through transrectal or transvaginal approach (3). The transgluteal or presacral approach are alternatives with CT guidance in these locations (4-13).