Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous
CPT4 code
Name of the Procedure:
Image-guided fluid collection drainage by catheter (e.g., abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous.
Summary
This procedure involves using imaging technology to guide the insertion of a catheter to drain fluid collections such as abscesses, hematomas, seromas, lymphoceles, or cysts located in the peritoneal or retroperitoneal areas of the body. It is performed percutaneously, meaning through the skin.
Purpose
This procedure is designed to address conditions where fluid accumulates abnormally within the body. The main goals are to alleviate symptoms, prevent infection or other complications, and promote faster recovery.
Indications
- Presence of abscesses, hematomas, seromas, lymphoceles, or cysts.
- Symptoms such as pain, swelling, or signs of infection.
- Fluid collection verified by diagnostic imaging.
- Patients who are not candidates for more invasive surgical procedures.
Preparation
- Patients may be instructed to fast for a certain period before the procedure.
- Adjustments to medication might be necessary, especially blood thinners.
- Pre-procedure imaging tests (e.g., ultrasound, CT scan) to locate and assess the fluid collection.
- Blood tests to check for clotting function.
Procedure Description
- Patient is positioned based on the location of the fluid collection.
- Imaging technology (ultrasound, CT, or fluoroscopy) is used to precisely locate the fluid.
- Local anesthesia is applied to numb the area.
- A small incision is made in the skin.
- A needle is inserted to reach the fluid collection.
- A guidewire is placed through the needle, followed by the catheter.
- The catheter is secured and connected to a drainage bag.
- Imaging is used throughout to ensure accurate placement.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
The procedure is usually performed in a hospital's radiology department or an outpatient surgical center.
Personnel
- Interventional radiologist or surgeon
- Radiologic technologist
- Nurse
- Anesthesiologist (if sedation is used)
Risks and Complications
- Infection at the insertion site
- Bleeding or hematoma formation
- Injury to nearby organs or structures
- Catheter displacement or blockage
Allergic reactions to materials used (rare)
Benefits
- Relief from pain and discomfort due to fluid accumulation.
- Reduced risk of infection or complications associated with untreated fluid collections.
- Minimally invasive with a quick recovery time.
Recovery
- Patients may be observed for a few hours post-procedure.
- Instructions on catheter care and fluid output monitoring.
- Pain management prescriptions if necessary.
- Follow-up imaging to ensure complete drainage.
- Most patients can return to normal activities within a few days, avoiding strenuous activities until healed.
Alternatives
- Surgical drainage, which is more invasive and has a longer recovery time.
- Antibiotic therapy alone for some abscesses, though less effective without drainage.
- Aspiration, which might be less effective for larger, more complex fluid collections.
Patient Experience
During the procedure, patients will feel pressure but should have minimal pain due to local anesthesia. Post-procedure, some soreness at the insertion site is common. Pain management and comfort measures such as over-the-counter pain relievers may be recommended.