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GI & GU INTERVENTIONS
Image Guided Drainage of Abdominal and Pelvic Abscesses
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Percutaneous imaging-guided drainage has become the preferred treatment for infected or symptomatic fluid collections in the abdomen and pelvis in many cases. Imaging guidance for drainage is most commonly performed with ultrasonography (US), computed tomography, or US and fluoroscopy combined. Abscesses in locations that are difficult to access, such as those deep in the pelvis, subphrenic regions, or epigastric region, can also be drained in most cases.
Ultrasound or CT is used to locate the abscess and to provide guidance for the site of needle insertion. In the case of ultrasound, direct visualization of the needle being inserted into the abscess is performed. If CT is used for guidance, CT scans are obtained intermittently to ensure that the needle is in the correct location. Once the needle is in the fluid collection, it is exchanged for a wire and subsequently a drainage catheter is passed over the wire into the abscess and this in turn is connected to an external bag to collect infected fluid. Further imaging (e.g. with CT) is used to confirm correct placement of the catheter and may be used again over the next few days to ensure that the abscess is being drained satisfactorily.
With expertise in imaging-guided drainage techniques, interventional radiologists can successfully drain most abscesses and obviate surgery.
Key Advantages:
- Can be performed under local anesthesia
- Can eliminate the need for further surgery
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