Ultrasound-guided abscess drainage
Author:
Mikael Häggström [notes 1]
Contents
Planning
Coagulation
SuperficialThis procedure counts as conferring a relatively low risk of clinically significant bleeding when being superficial, such as in the neck, thoracic wall, abdominal wall or limbs, and the following bleeding precautions refer to such cases.[1] Required lab testProthrombin time (PT or INR):
Lab interpretation
Anticoagulant medication
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Thorax or abdomenThis procedure counts as conferring a moderate risk of clinically significant bleeding being deeper into the thorax or abdomen, and the following bleeding precautions refer to such cases.[2] Required lab testProthrombin time (PT or INR):
Lab interpretation
Anticoagulant medication
|
Procedure
1. Ask for any allergic reaction to local anesthetics
2. Check proper puncture location with ultrasonography.
- The puncture location can be marked by a skin impression (such as a pen with withdrawn nib), or with a skin marker (which may, however, disappear during washing).
- For more superficial abscesses, consider memorizing the expected depth and direction of the catheter insertion in order to do it without simultaneous ultrasonography.
3. The skin area is washed with an antiseptic
4. Wear at least sterile gloves, and use sterile coverage on the ultrasound probe if using it during the puncture.
5. Preferably use a pigtail catheter. For liver abscesses the sizes range between 6–14 French, with a median of 10 French.[3]
6. Have a scalpel ready for skin incision
7. Infuse local anesthetic, such as 10 - 20 ml of 1% carbocaine, along the planned puncture direction
8. Make a skin incision large enough for the catheter to pass
9. Insert the catheter with the cannula until reaching within the abscess.
10. Loosen the cannula from the catheter, and advance the catheter only.
11. Withdraw the cannula
12. Check for return, and note the color of any fluid. Attach plug, syringe or bag to the external tip.
13. Twist any pigtail of the catheter
14. Fixate the external part to the skin
Report
- Size of catheter.
- Presence or absence of complications.
- Color of the fluid.
- See also: General notes on reporting
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
References
- ↑ The coagulation section follows local practice at: NU Hospital Group, Sweden
- ↑ The coagulation section follows local practice at: NU Hospital Group, Sweden
- ↑ Dulku, Gurjeet; Mohan, Geeta; Samuelson, Shaun; Ferguson, John; Tibballs, Jonathan (2015). "Percutaneous aspiration versus catheter drainage of liver abscess: A retrospective review ". Australasian Medical Journal: 7–18. doi: . ISSN 18361935.