Name of the Procedure:

Image-guided fluid collection drainage by catheter (e.g., abscess, hematoma, seroma, lymphocele, cyst), soft tissue (e.g., extremity, abdominal wall, neck), percutaneous

Summary

Image-guided fluid collection drainage by catheter is a minimally invasive procedure used to remove abnormal fluid accumulations in soft tissues, such as abscesses, hematomas, seromas, lymphoceles, or cysts. The procedure uses imaging technology to guide the placement of a catheter, which drains the fluid.

Purpose

This procedure addresses the accumulation of fluids in soft tissues due to various medical conditions, such as infections leading to abscesses or trauma resulting in hematomas. The goals are to relieve symptoms, prevent infection or further complications, and promote healing.

Indications

• Persistent or painful fluid collections (abscesses, hematomas, seromas, lymphoceles, or cysts)
• Infections not responding to antibiotic therapy
• Symptoms like pain, swelling, or fever
• Diagnostic imaging revealing fluid that requires drainage

Preparation

• Fasting for several hours before the procedure, typically 6-8 hours
• Adjustment or temporary discontinuation of certain medications, particularly blood thinners
• Pre-procedure imaging tests such as ultrasound, CT scan, or MRI to locate the fluid collection accurately
• Blood tests to check coagulation status

Procedure Description

1. The patient is positioned and the skin over the fluid collection is cleaned and sterilized.
2. Local anesthesia is applied to numb the area.
3. Using imaging guidance (ultrasound or CT), the physician inserts a needle into the fluid collection.
4. A catheter is placed through the needle into the fluid pocket.
5. The needle is removed, leaving the catheter in place to drain the fluid.
6. The catheter may be left in place for several days to ensure complete drainage and may be connected to a drainage bag.

Duration

The procedure typically takes 30 minutes to 1 hour, depending on the complexity and location of the fluid collection.

Setting

This procedure is performed in a hospital's radiology or interventional radiology department, outpatient clinic, or surgical center.

Personnel

• Interventional radiologist or surgeon
• Radiologic technologist
• Nursing staff
• Anesthesiologist or sedation nurse, if necessary

Risks and Complications

• Infection at the catheter insertion site
• Bleeding or hematoma formation
• Injury to surrounding tissues or organs
• Allergic reaction to contrast materials used in imaging
• Catheter blockage or displacement

Benefits

• Relief from pain and discomfort caused by fluid collection
• Reduced risk of infection and other complications from untreated fluid accumulation
• Quick recovery time due to the minimally invasive nature of the procedure

Recovery

• Monitoring for a few hours post-procedure to ensure stability
• Instructions on how to care for the catheter site
• Possible antibiotics to prevent infection
• Follow-up imaging to ensure complete drainage
• Most patients can resume normal activities within a few days, with some restrictions on strenuous activities

Alternatives

• Surgical drainage, which may be more invasive and require a longer recovery time
• Needle aspiration without catheter placement, suitable for smaller or easily accessible fluid collections
• Observation and medical management with antibiotics alone, appropriate for some uncomplicated infections

Patient Experience

During the procedure, the patient may feel pressure or slight discomfort when the needle is inserted. Local anesthesia minimizes pain. After the procedure, there may be some mild soreness at the catheter site, which can be managed with over-the-counter pain medications. Comprehensive instructions are provided to ensure a smooth recovery process.