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[Percutaneous pleural and pericardial drainage]

A Drolsum1, A Skjennald

  • 1Røntgenavdelingen, Ullevål sykehus, Oslo.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|November 20, 1994
PubMed
Summary

Image-guided percutaneous procedures effectively manage pleural and pericardial fluid collections. Sonography is ideal for real-time guidance, with CT as a backup, enabling safe and efficient interventions.

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Area of Science:

  • Medical Imaging
  • Interventional Radiology
  • Thoracic Surgery

Context:

  • Pleural and pericardial fluid collections require accurate diagnosis and management.
  • Various imaging modalities including MRI, CT, and sonography can visualize these collections.
  • Image-guided percutaneous procedures offer minimally invasive therapeutic options.

Purpose:

  • To evaluate the role of imaging modalities in guiding percutaneous procedures for pleural and pericardial fluid collections.
  • To highlight sonography's advantages in real-time guidance for interventions.
  • To discuss the indications, techniques, and potential complications of these procedures.

Summary:

  • Sonography is the preferred imaging method for guiding interventions due to its real-time visualization capabilities, crucial for precise needle and catheter placement.
  • CT serves as a valuable guidance system when ultrasound visualization is suboptimal, particularly when air obscures the fluid collection.
  • Procedures like thoracocentesis and pericardiocentesis are performed for diagnostic (malignancy, infection) and therapeutic (dyspnea relief, empyema drainage, cardiac tamponade management) purposes.
  • Complications such as pneumothorax can be managed during the procedure, and image-guided interventions are generally safe with no absolute contraindications other than coagulation abnormalities.

Impact:

  • Image-guided percutaneous procedures provide effective, minimally invasive treatment for pleural and pericardial effusions.
  • These techniques allow for rapid symptom relief, particularly in cases of cardiac tamponade and dyspnea due to pleural effusions.
  • The use of local anesthesia and management of potential complications like pneumothorax contribute to the safety and feasibility of these interventions.

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