49021 Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess; percutaneous

Name of the Procedure:

Drainage of Peritoneal Abscess or Localized Peritonitis, Exclusive of Appendiceal Abscess; Percutaneous

Summary

This procedure involves using a needle or small tube to drain pus or infected fluid from the abdominal cavity, specifically targeting peritoneal abscesses that are not related to the appendix. The drainage is done through the skin, avoiding the need for open surgery.

Purpose

The procedure is intended to treat infections within the peritoneal cavity by draining abscesses or localized infections. The goal is to remove the infected material, reduce infection and inflammation, and promote faster recovery.

Indications

• Presence of a peritoneal abscess detected via imaging tests (e.g., CT scan, ultrasound)
• Symptoms such as severe abdominal pain, fever, and tenderness indicating infection
• Failure of antibiotic treatment to resolve the abscess
• Patient is a suitable candidate for a minimally invasive procedure without needing open surgery

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Blood tests, imaging studies, and a physical examination will be conducted beforehand.
• Patients may need to stop certain medications as advised by their healthcare provider.

Procedure Description

1. The patient lies on an examination table. Local anesthesia is applied to numb the skin.
2. Using imaging guidance (ultrasound or CT scan), the exact location of the abscess is identified.
3. A small needle or catheter is inserted through the skin and into the abscess.
4. Pus or infected fluid is aspirated or drained through the catheter.
5. The catheter may be left in place for continued drainage, if necessary.
6. The area is cleaned, and a small bandage is applied to the insertion site.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

This procedure is performed in a hospital, often in the radiology or interventional suite, under sterile conditions.

Personnel

• Interventional radiologist or surgeon
• Radiology technician
• Nurses
• Anesthesiologist or sedation nurse (if sedation is used)

Risks and Complications

• Infection at the insertion site
• Bleeding or hematoma
• Injury to nearby organs or structures
• Incomplete drainage, requiring additional procedures
• Rare risk of sepsis

Benefits

• Minimally invasive with a faster recovery compared to open surgery
• Effective resolution of the abscess and relief of symptoms
• Reduced infection and inflammation

Recovery

• Patients may be observed for a few hours after the procedure.
• Pain and discomfort at the insertion site can be managed with pain medication.
• Patients should follow up with their healthcare provider and may need repeat imaging to ensure the abscess has resolved.
• Recovery involves a few days of rest and gradually resuming normal activities.

Alternatives

• Open surgical drainage, which is more invasive and involves a longer recovery time
• Continued antibiotic therapy alone, which may not always be effective in draining the abscess
• Laparoscopic drainage, which is also minimally invasive but may not be suitable for all abscess locations

Patient Experience

During the procedure, the patient may feel pressure or mild discomfort but should not experience significant pain due to local anesthesia. Post-procedure, there may be some soreness at the insertion site. Pain management and care instructions will help ensure comfort and a smooth recovery.