Definition & Overview

Image-guided fluid collection drainage by catheter is the procedure of removing fluid buildup from several parts of the body. Unlike in aspiration procedure in which the catheter is immediately removed after fluid collection, drainage entails leaving the catheter in place for a period of time for the continuous removal of excess fluid. The procedure is applicable in treating several types of medical conditions, such as abscess, seroma, cysts, hematoma, and lymphocele.

There are several types of imaging technologies used in fluid drainage using catheter, including:

Fluoroscopy, which uses x-ray beams to pass through the body and collect continuous images transmitted to a monitor

• Ultrasound imaging or sonography, which uses high-frequency sound waves to obtain real-time images of internal organs and structures

• Magnetic resonance imaging, in which strong magnetic fields are combined with radio waves to create and transmit images from the scanners to monitors

• Computed tomography, which uses a special type of x-ray to obtain cross-sectional images of internal body parts


All these imaging technologies help in the accurate placement of the catheter needle and avoid any unnecessary damages to nearby structures.

Who Should Undergo and Expected Results

Those who qualify for the procedure include:

  • Patients suffering from abscess or a collection of infected fluid characterised by fever, chills, and general body pain. Abscess typically develops after a major surgical procedure or infection to a particular body part.

  • Patients with seromas following plastic or cosmetic surgery. This refers to the collection of fluid just beneath the surface of the skin where surgery was performed. People who undergo breast augmentation, tummy tuck, or body contouring often develop seromas a few weeks after surgery.

  • Patients with lymphocele – Surgery patients can also develop a buildup of lymph fluid called a lymphocele, which is quite common among patients who undergo surgery in the pelvis and is usually located in the retroperitoneal cavity

  • Patients with fluid-filled cysts – These cysts can develop in almost any part of the body and this procedure is quite effective in removing them safely

  • Patients with hematoma, especially those with significant swelling filled with blood. Hematoma is often associated with pain, redness, and oedema.
    Patients are typically placed under close medical supervision during and after the procedure and are advised to rest for several days and avoid any extraneous physical activity. The physician is expected to evaluate the catheter entry site several times even after it has been removed to ensure no subsequent infection develops. This procedure is considered quite successful in removing any fluid buildup in affected body areas and alleviating the pain and discomfort of patients.

How is the Procedure Performed?

Patients are usually sedated throughout the procedure. After determining the location where the catheter is to be inserted, the physician applies local anaesthesia and sterilises the target area. Some areas may also be shaved. The imaging tool is then properly positioned, depending on the type of equipment deemed suitable for the procedure. The physician then makes a small incision and inserts the catheter. The insertion of the catheter can be performed using different techniques. The single stage technique involves inserting the catheter directly under the skin and into the affected site to commence draining the fluid while the multiple stage technique involves inserting an introducer needle first under the skin. A stiff wire is then made to pass, with a dilatator expanding the entry point of the catheter. To ensure that the catheter stays in place, a locking drain is used. When the catheter is sufficiently secured, a draining bag is attached to contain the collected fluid. The catheter remains in place until all excess fluid is drained and the infection has been resolved.

Possible Risks and Complications

  • Infection at the insertion site
  • Allergic reaction from contrast substances injected for imaging
  • Bleeding during the insertion and guidance of catheter into the affected site
  • Fluid buildup recurrence

References: * Mortele KJ, Girshman J, Szejnfeld D, et al. CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis: clinical experience and observations in patients with sterile and infected necrosis. AJR Am J Roentgenol. 2009 Jan. 192(1):110-6. * Yamakado K, Takaki H, Nakatsuka A, et al. Percutaneous transhepatic drainage of inaccessible abdominal abscesses following abdominal surgery under real-time CT-fluoroscopic guidance. Cardiovasc Intervent Radiol. 2010 Feb. 33(1):161-3.

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