Scribd Logo
Upload

Welcome to Scribd!

  • 22 views

    Ultrasound Guided Percutaneous Drainage

    Uploaded by

    Laraib Fatima
    Ultrasound guided percutaneous drainage allows minimally invasive treatment of fluid collections accessible by ultrasound. It has advantages over CT like being a dynamic study allowing greater precision, not using radiation, and requiring less staff. Disadvantages include some targets being poorly visualized and bowel gas or patient size obscuring views. Indications broadly include any abnormal fluid collection like abscesses. Contraindications are inaccessible targets or bleeding risks. Safety requires a platelet count over 50,000 and INR below 1.5. The technique involves entering the collection directly or using dilators over a wire before catheter placement. Post procedure care includes monitoring and mobilization after 2 hours.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Ultrasound Guided Percutaneous Drainage

    Uploaded by

    Laraib Fatima
    22 views3 pages
    Ultrasound guided percutaneous drainage allows minimally invasive treatment of fluid collections accessible by ultrasound. It has advantages over CT like being a dynamic study allowing greater precision, not using radiation, and requiring less staff. Disadvantages include some targets being poorly visualized and bowel gas or patient size obscuring views. Indications broadly include any abnormal fluid collection like abscesses. Contraindications are inaccessible targets or bleeding risks. Safety requires a platelet count over 50,000 and INR below 1.5. The technique involves entering the collection directly or using dilators over a wire before catheter placement. Post procedure care includes monitoring and mobilization after 2 hours.

    Original Title

    Ultrasound guided percutaneous drainage

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Ultrasound guided percutaneous drainage allows minimally invasive treatment of fluid collections accessible by ultrasound. It has advantages over CT like being a dynamic study allowing greater precision, not using radiation, and requiring less staff. Disadvantages include some targets being poorly visualized and bowel gas or patient size obscuring views. Indications broadly include any abnormal fluid collection like abscesses. Contraindications are inaccessible targets or bleeding risks. Safety requires a platelet count over 50,000 and INR below 1.5. The technique involves entering the collection directly or using dilators over a wire before catheter placement. Post procedure care includes monitoring and mobilization after 2 hours.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    22 views3 pages

    Ultrasound Guided Percutaneous Drainage

    Uploaded by

    Laraib Fatima
    Ultrasound guided percutaneous drainage allows minimally invasive treatment of fluid collections accessible by ultrasound. It has advantages over CT like being a dynamic study allowing greater precision, not using radiation, and requiring less staff. Disadvantages include some targets being poorly visualized and bowel gas or patient size obscuring views. Indications broadly include any abnormal fluid collection like abscesses. Contraindications are inaccessible targets or bleeding risks. Safety requires a platelet count over 50,000 and INR below 1.5. The technique involves entering the collection directly or using dilators over a wire before catheter placement. Post procedure care includes monitoring and mobilization after 2 hours.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 3

    Ultrasound guided percutaneous drainage 

    is one form of image guided procedure, allowing


    minimally invasive treatment of collections that are accessible by ultrasound study.

    It has several advantages and disadvantages over CT, which include:

    Advantages
     is a dynamic study, allowing greater precision to control needle insertion
     does not expose patients to ionizing radiation
     does not require as wide a range of staff, compared to CT-guided procedures

    Disadvantages
     deeper targets may not be as well-visualized on ultrasound (e.g. retroperitoneal nodes)
     bowel gas may obscure visualization
     attenuation of the sound beam on larger patients

    Indications
    Indications for percutaneous drainage are broad: essentially any abnormal fluid collection in the
    patient which can be accessible. Examples include:

     complicated diverticular abscess


     Crohn's disease related abscess
     complicated appendicitis with appendicular abscess
     tuboovarian abscess
     post-surgical fluid collections
     hepatic abscess (e.g. amoebic or post-operative)
     renal abscess or retroperitoneal abscess
     splenic abscess

    Contraindications
    The only common contraindications are:

     biopsy target is not accessible


     patient has a bleeding diathesis

    Procedure

    Laboratory parameters for a safe procedure


    Interventional procedures like percutaneous drainage require special attention to coagulation
    indices. There are widely divergent opinions about the safe values of these indices for
    percutaneous biopsies. The values suggested below were considered based on a literature review.

    Complete blood count: platelet count > 50000/mm3  (Some institutions determine other values
    between 50000-100000/mm3) 1

    Coagulation profile:

     international normalized ratio (INR) ≤1.5 1


     normal prothrombin time (PT), partial thromboplastin time (PTT)
    Some studies show that having a normal INR or prothrombin time is no reassurance that the
    patient will not bleed after the procedure 2.

    Pre-procedure evaluation
    Review other diagnostic studies first to clarify the collection that is requested to be drained. An
    ultrasound study should be done prior to the procedure to decide the access angle and check the
    relationship of the collection to adjacent structures. In general, the shortest possible route is
    preferred, as long as it does not traverse other structures.

    Technique
    Ultrasound guided percutaneous drainage may be performed with a single or multiple stage
    technique.

    In the single stage technique, the fluid collection is entered directly with a catheter, typically
    either 8F or 12F in size.

    The multiple step technique utilizes the modified Seldinger technique, whereby the abscess is
    entered with an introducer needle, through which a stiff wire is passed. The track is then
    expanded with a dilator or serial dilators, before the catheter is passed over the wire to gain the
    final position within the abscess. A locking drain is typically used to ensure a secure position.
    The catheter is then connected to an external drainage bag.

    Post-procedure care
    The patient's basic vital signs should be monitored for 4 hours post procedure (pulse, blood
    pressure, SpO2), or as long as deemed necessary.

    The patient should remain in bed for 2 hours. After this period, mobilization and oral intake are
    permitted.

    The entry site should be reviewed on a daily basis. If output from the collection ceases, it may
    mean that the collection is no longer present or that the drain is clogged. Re-imaging and/or
    flushing the drain should be considered before removing the drainage catheter.

    You might also like