Definition & Overview

Percutaneous image-guided fluid collection and drainage of soft tissue by catheter is a procedure of treating abscesses and other fluid buildup in the neck, abdominal wall, and extremities. It involves inserting a catheter and placing a small drain through the skin to remove the accumulated fluid, all the while using imaging technologies for accuracy.

The evolution of percutaneous fluid collection techniques, particularly in treating abscesses, has become more popular in the last few decades. Most physicians prefer this procedure over open surgical process in treating fairly superficial fluid buildup. The use of lytic agents that causes the destruction of cells often means this procedure can be employed in removing even viscous fluid that may have a mixture of debris and blood components.

The advent of advanced imaging techniques also contributed to the continued success and use of the procedure. Among the imaging technologies used are computed tomography (CT), ultrasound, x-ray, and even magnetic resonance imaging (MRI).

Who Should Undergo and Expected Results

Patients who are suffering from neck abscess may be advised to undergo the procedure. This condition typically develops due to trauma, as a result of respiratory infection, the introduction of foreign bodies, and even as a result of dental infections. Neck abscess can develop anywhere in the neck region and can be fatal if left unattended. In some cases, it can lead to the destruction of the airway and impair pulmonary functions.

Fluid buildup in the abdominal area may also necessitate draining through catheter. These buildups may be caused by abscess in the stomach wall, leaks from different parts of the digestive system such as the bowel, bile ducts, pancreas, and even leaks coming from the urinary tract.

In some cases, patients may develop fluid buildup right beneath the skin of arms and legs. They may be diagnosed with abscess, hematomas, seromas, or bulla underneath the skin. These conditions can also be alleviated with the use percutaneous fluid collection drainage by catheter.

Using catheter and advanced imaging technology is considered a safe method of draining excess fluid that accumulated in soft tissues under the skin and in the gastric wall. This procedure has good success rate and patients report satisfaction with the results. It is less invasive compared to open surgical drainage and thus entails less recovery time. Patients are asked to rest after this procedure and avoid extraneous physical activity. They would also need to make several follow-up visits to make sure no complications arise from the procedure. In some cases, complete drainage is achieved after a few days.

How is the Procedure Performed?

Depending on the location of the fluid buildup, patients may be sedated or local anesthetics may be applied to the affected site. The surgical site is prepared by sterilising and shaving off excess hair.

There are several ways of obtaining the images of internal body parts to aid in this procedure. The patient may be asked to lie on an examination table and is made to go inside the CT scanner to obtain images and visualisation of the location where the fluid has accumulated.

If an ultrasound scanner is used, a small amount of gel is applied and the body part is scanned using a transducer. The high-frequency sound waves help creates images that will help the physician locate and examine any abnormality.

The physician may also use X-ray or MRI scanners in guiding the catheter inside the body. Once the fluid buildup is properly located, a small incision is made and a long plastic tube, called a catheter, is inserted. The physician guides the catheter into place where drainage is needed. The tube is locked in place and attached to a drainage bag to collect the fluid. The catheter will remain inside the body until all excess fluid is removed.

Possible Risks and Complications

The patient has a very slight change of developing an infection and allergic reactions, especially if contrast material for imaging was injected.

Though rare, there are also cases in which the nearby organs or body parts were injured following the insertion of the catheter.

Large fluid buildup may require several days to completely drain away. Some patients may displace or block their catheter during the course of the drainage and might need to have it fixed or replaced by the physician.


References:

  • Bennett J D, Kozak R I, Taylor B M, Jory T A. Deep pelvic abscesses: transrectal drainage with radiologic guidance. Radiology. 1992;185:825–828.

  • O'Neill M J, Rafferty E A, Lee S I, et al. Transvaginal interventional procedures: aspiration, biopsy, and catheter drainage. Radiographics. 2001;21:657–672.

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