766 - Pediatric Interventional Radiology in Pediatric and Adolescent Gynecology: A Multidisciplinary Approach to Complex Genitourinary Conditions

Learning Objectives:

1. To illustrate, through case presentations, image-guided procedures in the evaluation and management of various complex pediatric and adolescent gynecologic conditions.


2. To illustrate optimal imaging evaluation in patients with vascular malformations, obstructive Müllerian anomalies, infection, bleeding, and malignancy within the female genitourinary tract.


3. To emphasize the importance of multidisciplinary evaluation and management of pediatric and adolescent gynecologic pathology incorporating interventional radiology expertise.

Background: Image-guided procedures can be helpful in diagnosing and managing complex pediatric and adolescent gynecologic conditions. Although some patients will require surgical intervention, the imaging expertise coupled with the endovascular and percutaneous skill set of the pediatric Interventional Radiologist (IR) is important in defining the problem, bridging to definitive surgical management, optimizing surgical outcomes, and in some cases, providing definitive treatment.

Clinical Findings/Procedure Details: We present a case series illustrating the types of conditions encountered, optimal imaging evaluation of these pathologies, and various percutaneous and endovascular techniques used to manage complex pediatric and adolescent gynecologic conditions as part of a multidisciplinary team. Cases include vascular malformations requiring targeted embolization and sclerotherapy, external genital trauma with selective arterial embolization for hemorrhage control, spontaneous bleeding secondary to coagulopathy, tubo-ovarian abscesses managed with image-guided drainage, image-guided biopsies, and obstructive Müllerian anomalies leading to hematometrocolpos requiring coordinated surgical intervention with IR and gynecology.

Conclusion and/or Teaching Points: The expertise of interventional radiologists can be helpful in the multidisciplinary management of complex adolescent gynecologic patients, providing minimally invasive treatment, assistance in gynecologic surgeries, or in some cases, definitive management.