Transpleural (TP): Evacuation of pneumothorax (apical) or drainage of effusion/empyema (basilar)
Transabdominal (TA): Through anterior/lateral abdomen, generally shortest route, most easily tolerated by patients
Transgluteal (TG): Access deep pelvis when obscured anteriorly by bowel, often more painful than TA approach
Transrectal (TR): Access prostatic abscess or collections anterior/posterior to rectum
Transvaginal (TV): Access pelvic collections anterior to rectum
Tunneled pleural/peritoneal drainage: Palliative drainage of pleural effusion/ascites via long-term indwelling catheter that is tunneled subcutaneously
Often for malignancy but can be for benign end-stage disease (e.g., heart failure or cirrhosis)
Sclerotherapy: Injection of sclerosant via indwelling drain for treatment of high-output collection
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Drain Catheter Removal Criteria
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Expected Outcomes
Selected References
De Filippo M et al: CT-guided percutaneous drainage of abdominopelvic collections: a pictorial essay. Radiol Med. 126(12):1561-70, 2021
Episalla NC et al: Sclerotherapy as an alternative treatment for complex, refractory seromas. J Surg Case Rep. 2021(8):rjab224, 2021
Kodzis E et al: Common options and overlooked alternative for drainage of inaccessible presacral abscess: a case report. Acta Med Litu. 28(1):170-5, 2021
Lui MM et al: Complications of indwelling pleural catheter use and their management. BMJ Open Respir Res. 3(1):e000123, 2016
Yong L et al: Abdominal drainage versus no abdominal drainage for laparoscopic cholecystectomy: a systematic review with meta-analysis and trial sequential analysis. Int J Surg. 36(Pt A):358-68, 2016
Gee MS et al: Management of abdominal and pelvic abscesses that persist despite satisfactory percutaneous drainage catheter placement. AJR Am J Roentgenol. 194(3):815-20, 2010
Merritt RE et al: Evidence-based suggestions for management of air leaks. Thorac Surg Clin. 20(3):435-48, 2010
Josephson T et al: Amount drained at ultrasound-guided thoracentesis and risk of pneumothorax. Acta Radiol. 50(1):42-7, 2009
Beland MD et al: Complex abdominal and pelvic abscesses: efficacy of adjunctive tissue-type plasminogen activator for drainage. Radiology. 247(2):567-73, 2008
Gervais DA et al: Adjunctive intrapleural tissue plasminogen activator administered via chest tubes placed with imaging guidance: effectiveness and risk for hemorrhage. Radiology. 246(3):956-63, 2008
Saokar A et al: Transvaginal drainage of pelvic fluid collections: results, expectations, and experience. AJR Am J Roentgenol. 191(5):1352-8, 2008
Feller-Kopman D et al: Large-volume thoracentesis and the risk of reexpansion pulmonary edema. Ann Thorac Surg. 84(5):1656-61, 2007
Gervais DA et al: Recurrent abdominal and pelvic abscesses: incidence, results of repeated percutaneous drainage, and underlying causes in 956 drainages. AJR Am J Roentgenol. 182(2):463-6, 2004
Maher MM et al: The inaccessible or undrainable abscess: how to drain it. Radiographics. 24(3):717-35, 2004
Harisinghani MG et al: Transgluteal approach for percutaneous drainage of deep pelvic abscesses: 154 cases. Radiology. 228(3):701-5, 2003
Titton RL et al: Urine leaks and urinomas: diagnosis and imaging-guided intervention. Radiographics. 23(5):1133-47, 2003
Gervais DA et al: Percutaneous abscess drainage in Crohn disease: technical success and short- and long-term outcomes during 14 years. Radiology. 222(3):645-51, 2002
Harisinghani MG et al: CT-guided transgluteal drainage of deep pelvic abscesses: indications, technique, procedure-related complications, and clinical outcome. Radiographics. 22(6):1353-67, 2002
O'Neill MJ et al: Transvaginal interventional procedures: aspiration, biopsy, and catheter drainage. Radiographics. 21(3):657-72, 2001
Moulton JS: Image-guided management of complicated pleural fluid collections. Radiol Clin North Am. 38(2):345-74, 2000
vanSonnenberg E et al: Percutaneous drainage of thoracic collections. J Thorac Imaging. 13(2):74-82, 1998
Gazelle GS et al: Abdominal abscess. Imaging and intervention. Radiol Clin North Am. 32(5):913-32, 1994
Morrison MC et al: Sclerotherapy of malignant pleural effusion through sonographically placed small-bore catheters. AJR Am J Roentgenol. 158(1):41-3, 1992
Silverman SG et al: Thoracic empyema: management with image-guided catheter drainage. Radiology. 169(1):5-9, 1988
vanSonnenberg E et al: CT- and ultrasound-guided catheter drainage of empyemas after chest-tube failure. Radiology. 151(2):349-53, 1984
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Definitions
Aspiration: Placement of needle/catheter for fluid removal
Thoracentesis/paracentesis: Aspiration of pleural effusion/ascites
Diagnostic fluid sampling from small or technically challenging collections
Drainage: Placement of indwelling catheter for fluid/air removal
Trocar technique: Advancing drain directly into collection over sharp inner stiffener
1 stick, typically shorter duration than Seldinger
Often used for shallow, larger collections
Seldinger technique: Tracking drain into collection over wire that has been previously advanced into collection through hollow access needle
Transpleural (TP): Evacuation of pneumothorax (apical) or drainage of effusion/empyema (basilar)
Transabdominal (TA): Through anterior/lateral abdomen, generally shortest route, most easily tolerated by patients
Transgluteal (TG): Access deep pelvis when obscured anteriorly by bowel, often more painful than TA approach
Transrectal (TR): Access prostatic abscess or collections anterior/posterior to rectum
Transvaginal (TV): Access pelvic collections anterior to rectum
Tunneled pleural/peritoneal drainage: Palliative drainage of pleural effusion/ascites via long-term indwelling catheter that is tunneled subcutaneously
Often for malignancy but can be for benign end-stage disease (e.g., heart failure or cirrhosis)
Sclerotherapy: Injection of sclerosant via indwelling drain for treatment of high-output collection
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Drain Catheter Removal Criteria
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Expected Outcomes
Selected References
De Filippo M et al: CT-guided percutaneous drainage of abdominopelvic collections: a pictorial essay. Radiol Med. 126(12):1561-70, 2021
Episalla NC et al: Sclerotherapy as an alternative treatment for complex, refractory seromas. J Surg Case Rep. 2021(8):rjab224, 2021
Kodzis E et al: Common options and overlooked alternative for drainage of inaccessible presacral abscess: a case report. Acta Med Litu. 28(1):170-5, 2021
Lui MM et al: Complications of indwelling pleural catheter use and their management. BMJ Open Respir Res. 3(1):e000123, 2016
Yong L et al: Abdominal drainage versus no abdominal drainage for laparoscopic cholecystectomy: a systematic review with meta-analysis and trial sequential analysis. Int J Surg. 36(Pt A):358-68, 2016
Gee MS et al: Management of abdominal and pelvic abscesses that persist despite satisfactory percutaneous drainage catheter placement. AJR Am J Roentgenol. 194(3):815-20, 2010
Merritt RE et al: Evidence-based suggestions for management of air leaks. Thorac Surg Clin. 20(3):435-48, 2010
Josephson T et al: Amount drained at ultrasound-guided thoracentesis and risk of pneumothorax. Acta Radiol. 50(1):42-7, 2009
Beland MD et al: Complex abdominal and pelvic abscesses: efficacy of adjunctive tissue-type plasminogen activator for drainage. Radiology. 247(2):567-73, 2008
Gervais DA et al: Adjunctive intrapleural tissue plasminogen activator administered via chest tubes placed with imaging guidance: effectiveness and risk for hemorrhage. Radiology. 246(3):956-63, 2008
Saokar A et al: Transvaginal drainage of pelvic fluid collections: results, expectations, and experience. AJR Am J Roentgenol. 191(5):1352-8, 2008
Feller-Kopman D et al: Large-volume thoracentesis and the risk of reexpansion pulmonary edema. Ann Thorac Surg. 84(5):1656-61, 2007
Gervais DA et al: Recurrent abdominal and pelvic abscesses: incidence, results of repeated percutaneous drainage, and underlying causes in 956 drainages. AJR Am J Roentgenol. 182(2):463-6, 2004
Maher MM et al: The inaccessible or undrainable abscess: how to drain it. Radiographics. 24(3):717-35, 2004
Harisinghani MG et al: Transgluteal approach for percutaneous drainage of deep pelvic abscesses: 154 cases. Radiology. 228(3):701-5, 2003
Titton RL et al: Urine leaks and urinomas: diagnosis and imaging-guided intervention. Radiographics. 23(5):1133-47, 2003
Gervais DA et al: Percutaneous abscess drainage in Crohn disease: technical success and short- and long-term outcomes during 14 years. Radiology. 222(3):645-51, 2002
Harisinghani MG et al: CT-guided transgluteal drainage of deep pelvic abscesses: indications, technique, procedure-related complications, and clinical outcome. Radiographics. 22(6):1353-67, 2002
O'Neill MJ et al: Transvaginal interventional procedures: aspiration, biopsy, and catheter drainage. Radiographics. 21(3):657-72, 2001
Moulton JS: Image-guided management of complicated pleural fluid collections. Radiol Clin North Am. 38(2):345-74, 2000
vanSonnenberg E et al: Percutaneous drainage of thoracic collections. J Thorac Imaging. 13(2):74-82, 1998
Gazelle GS et al: Abdominal abscess. Imaging and intervention. Radiol Clin North Am. 32(5):913-32, 1994
Morrison MC et al: Sclerotherapy of malignant pleural effusion through sonographically placed small-bore catheters. AJR Am J Roentgenol. 158(1):41-3, 1992
Silverman SG et al: Thoracic empyema: management with image-guided catheter drainage. Radiology. 169(1):5-9, 1988
vanSonnenberg E et al: CT- and ultrasound-guided catheter drainage of empyemas after chest-tube failure. Radiology. 151(2):349-53, 1984
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