What is Image Guided Drainage?
Image Guided Drainage is a minimally invasive technique in which interventional radiology uses ultrasound or CT scanning to accurately place a small drainage catheter into an abnormal fluid collection such as an abscess, cyst, haematoma, biloma, or pleural effusion anywhere in the body. This targeted approach drains infected or excess fluid safely and efficiently, relieving pain and treating infection far faster than conventional surgical drainage. The procedure is performed under local anaesthesia through a tiny skin puncture, leaving no surgical wound.
Who is this procedure for?
This procedure is suitable for patients with a confirmed or suspected collection of fluid, pus, or blood that needs to be drained to relieve symptoms or treat infection. Common indications include liver, lung, or abdominal abscesses, post-operative fluid collections, empyema (pus in the chest), pancreatic pseudocysts, and large symptomatic pleural or pericardial effusions. It is especially valuable for patients who are poor surgical candidates due to multiple co-morbidities, advanced age, or ongoing anticoagulation therapy.
How is the procedure performed?
- Cross-sectional imaging (ultrasound or CT) is performed to map the fluid collection, identify its dimensions, and plan the safest drainage route.
- The patient's skin is cleaned with antiseptic, sterile drapes are applied, and local anaesthetic is administered at the access site.
- Using real-time imaging guidance, a thin needle is passed into the fluid collection and a guidewire is introduced through the needle.
- The needle is exchanged over the guidewire for an appropriately sized drainage catheter (pigtail or straight), which is locked in place.
- The catheter is secured to the skin with a suture or adhesive dressing, and drainage begins immediately into a collection bag.
- The catheter is monitored daily with output recorded; imaging is repeated to confirm resolution, and the catheter is removed once drainage is complete and infection has cleared.
