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About Percutaneous Fluid Drainage – Thoracentesis and Paracentesis

An abscess is a walled-off fluid infection within the body.

It may occur in the abdomen, pelvis, or less commonly, the lungs. Antibiotics are unable to penetrate an abscess, so the bacteria within the abscess cannot be effectively treated unless the abscess is drained. This can be accomplished by open surgery or a minimally invasive drain placement, depending on where the abscess is.

Abscess drainage, also known as percutaneous fluid drainage, is a procedure to drain an infection in the body by insertion of a thin tube or catheter into the abscess using imaging guidance — such as a CT scan, flouroscopy or ultrasound — to drain the infection. Success is immediately apparent if the infected contents are aspirated. This result is usually achieved, with rates exceeding 90% according to literature studies.

Thoracentesis is a procedure for draining the lungs, while paracentesis is a procedure for draining the abdomen.

Why Is Paracentesis Done

Paracentesis may be performed to:

  • Determine the cause of fluid building up in the belly.
  • Diagnose an infection in the peritoneal fluid.
  • Check for certain types of cancer (e.g. liver cancer).
  • Remove a large amount of fluid that is causing pain, causing difficulty breathing, or affecting how the kidneys or the intestines are functioning.
  • Check for damage after a belly injury.

Preparing for Percutaneous Fluid Drainage

Let your physician know about all the medications you are taking, including herbal supplements, and if you have any allergies, especially to medications, anesthesia, or contrast materials containing iodine (sometimes referred to as “dye” or “x-ray dye”). You may be advised to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) and-or blood thinners before your procedure. Women should always inform the staff if there is any possibility that they are pregnant.

Other than medications, you may be instructed to not eat or drink anything for several hours before your procedure. You will be given a gown to wear during the procedure and will be asked to sign a consent form. Speak with your physician about why you are having the test, its risks, how it is performed and what the results will mean.

Plan to stay overnight at the hospital following your procedure.

About the Abscess Drainage Procedure

During the procedure — which is generally performed in a hospital setting — you will be attached to a monitor so that IV medications can be given. The skin over your abscess will be cleaned and numbed. Using image guidance, the interventional radiologist will insert a tube into the abscess. The tube will be attached to a drainage bag outside of your body. More than one tube may be required depending on the condition of the abscess. The tube(s) will be left in place.

What should I expect after the procedure?
After the procedure, it is common to stay in the hospital at least one night to monitor and treat your pain and observe the amount of drainage from your tube. Your nurse will show you how to care for the drainage tube once you return home. Follow-up imaging will be scheduled to determine how long the tube will need to remain in place.

How successful is abscess drainage?

Although there are risks associated with abscess drainage, it does help rid the body of infection so that you can heal more quickly from the infection. Usually you will feel better the next day. It will almost certainly result in a great improvement in your medical condition.

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