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PROCEDURES/INTERVENTION RADIOLOGY

An abscess is a collection of infected fluid within the body. Percutaneous abscess drainage uses image guidance to place a needle or catheter through the skin into the abscess to remove or drain the infected fluid. Offers faster recovery than open surgery drainage. Percutaneous drainage consists of emptying an existing liquid collection inside the body, for diagnostic or therapeutic purposes, through the skin, with a minimal incision and without requiring the use of an operating room, anesthesia or surgical techniques, by introducing a small catheter inside the collection and guiding its placement with imaging techniques. Sometimes it is necessary to introduce substances into the collection, either for treatment or to sclerosis the cavity. Indications It is indicated in any liquid collection of a known or unknown nature. This includes abscesses, cysts, bruises, bilomas, urinomas, seromas, etc. The objective of the technique can be twofold: - Diagnosis: obtain enough liquid for analysis, in order to determine its nature or the type of germs contained in it (in case it is infectious). - Therapeutic: solve the collection and prevent it from reproducing again or accelerate its healing.

Percutaneous Abscess Drainage

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Paracentesis consists of the percutaneous puncture of the abdomen with a needle to extract the fluid retained in the abdominal cavity by different pathologies. A prick can be performed with a normal needle to extract a small amount of fluid and study its composition (diagnostic paracentesis) or, if it is necessary to remove a lot of fluid (sometimes several liters), it is pricked with a larger needle connected to a bottle through a tube (evacuating paracentesis). The advantages of an ultrasound-guided paracentesis decrease the risk of complications as well as avoid puncturing the viscera of the abdomen or vascular structures that can be potentially lethal.

ULTRASOUND-guided paracentesis

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Non-ultrasound-guided thoracentesis can have serious complications such as pneumothorax, reported between 20 and 39%. This complication can be reduced to 0% when the procedure is guided by ultrasonography. Ultrasound is a safe, fast, and effective procedure to define the specific site of catheter or probe placement for drainage of pleural fluid, being able to identify adjacent structures such as the diaphragm, lung parenchyma, or abdominal viscera. Ideally, it should be performed by the specialist at the same time as the thoracentesis, since a reduction in the incidence of pneumothorax has not been seen when the thoracic puncture is performed by the radiologist. Indications 1. Diagnostic: each fluid in the pleural cavity of unknown etiology, with the exception of patients in whom the clinical symptoms and the results of the complementary examinations suggest heart failure, dialysis patients, with hypoalbuminemia and / or liver cirrhosis (in these patients the puncture is indicated in case of lack of improvement after the applied treatment, as well as in case of fever, pleural pain or large amount of unilateral fluid). 2. Therapeutic: symptomatic compression of the lung by fluid in the pleural cavity (generally ≥1500 ml of fluid is not removed at one time). Contraindications 1. Absolute: they do not exist. 2. Relative: INR> 1.5 and aPTT> 2 × ULN, platelets <50,000 / µl, small amount of fluid (does not guarantee safe puncture), or skin infection at the planned puncture site.

ULTRASOUND-guided thoracentesis

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Ascites is the accumulation of fluid in the area surrounding the organs in the abdomen. When ascites is caused by cancer, it is called malignant ascites. Malignant ascites is very common in people with the following types of cancer: Breast cancer Colon cancer Cancer of the gastrointestinal tract, such as stomach and intestinal cancer Ovarian cancer Pancreatic cancer Uterine cancer Symptoms of ascites Ascites usually causes a lot of discomfort. People with ascites may have the following symptoms: Weight gain Shortness of breath, also called dyspnea Abdominal swelling Feeling of fullness or bloating Feeling of heaviness Indigestion Nausea or vomiting Changes in the navel Hemorrhoids, which cause a painful swelling near the anus Swollen ankles Fatigue Loss of appetite The performance of this ultrasound-guided procedure does not give a percentage of success for the peritoneal catheter placement technique as a therapeutic measure, being a minimally invasive technique that allows 100% success of the procedures, not registering complications or failures during the placement process. resulting in an agile and safe procedure for cancer / non-cancer patients suffering from ascites.

Ultrasound-Guided CAPD Catheter Insertion

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Venous catheterization is defined as the insertion of a biocompatible catheter in the intravascular, central or peripheral space, in order to administer fluids, drugs, parenteral nutrition and determine physiological constants. Its installation in intensive care units is usual. Ultrasound for central venous catheterization has multiple comparative studies against blind puncture. The aspects described in favor of ultrasound are: lower incidence of accidental arterial punctures, fewer unsuccessful attempts, less time to carry out the procedure, reduction in bruising and reduction of risk of infections. Profits - Visualization of vascular structures - Optimal needle location - Protection against perforation of the back wall of the VYI - False sense of security - Precise location of the catheter - Decrease in the time of the procedure - Decrease in the number of attempts - Low complication rate

Ultrasound-guided central venous catheter placement

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