The document discusses biopsy and drainage procedures. It provides details on: 1) Biopsy results being positive 70-100% of the time, with the lowest success for lymphoma. 2) Techniques for abdominal drainage including direct puncture and the Seldinger technique using various sterile materials. 3) Precautions for drainage including using a fine needle to determine fluid characteristics and never fully emptying before draining.

1. RESULTS OF BIOPSY
+ve diagnosis between 70 et 100%.
Least performance in lymphoma

2. ABDOMINAL COLLECTION
ASPIRATION & DRAINAGE

3. STERILE MATERIEL
Drainage
DIRECT METHOD SELDINGER TECHNIQUE
drain 1  Add 
Fixation system 1  Puncture needle 1 
way connector-3 1  guidewire 1 
tubular connection 1  dilator 1 
sterile urine bag 1 
Potentially suture kit and needle 
holder

4. Direct Puncture

5. Seldinger Technique

6. DRAINAGE
Fine needle allow to 
precise the nature of
. the fluid to drain
And to adapt caliber 
of drain
Never empty before 
draining

7. INTERVENTIONAL PROCEDURE
Radiologist perform disinfection with antiseptic iodinated
(.solution (Povidone
(. Locale anesthesia (Lidocaïne 1%
(Large skin incision (caliber of drain
.US-guided puncture and drain positioning
Technician may help for gain and depth adjustment of the US
machine, Doppler activation and good contact between probe
and skin by alcohol or betadine
(Fixation of drain by radiologist (2 zones of fixation
. Dressing is done by the technician
(Drainage bag is left dependant (never under aspiration

8. INTERVENTIONNEL
Collection Drain positioning
drain

9. DRAINAGE
(If guidwire too soft: risk of outside curve (curling 
If guidwire too rigid : risk posterior wall injury and 
.dissemination
No ‘locking’ pigtail catheter in abcess except transrectal or 
.vaginal abcess
Kinking of catheter in the wall 

10. AFTER THE INTERVENTIONAL PROCEDURE
.Verification of discharge flow in the drain
. Follow-up form & potential specimens joined
(Pt. lying on point of puncture (compression
.Patient sent back to his ward

11. FOLLOW-UP AFTER INTERVENTIONAL PROCEDURE
.Verification of discharge flow in the drain
Clinical state improvement
.Follow-up when no more discharge comes out
(Clamping Test (2-3j
If persistance : search for fistula

12. AFTER INTERVENTIONAL PROCEDURE
.Verification of discharge flow in the drain
Follow-up: Emptying – flush with10 cc normal saline
with re-aspiration - AB IV : no flushing
Decreasing discharge
Clamping Test after follow-up US and clinical
.improvement

13. Interventional Ultrasound
PATIENT
Skin cleaning in 4 steps
- detersion with cleaning solution
- Rince with Sodium Chloride
- Dry with sterile gauze
- Disinfection with antiseptic solution
In case of wound:
Cover the probe with sterile protection
Cover the lesion with transparent sterile dressing

14. Advantages
anatomy •
Content •
Disadvantages
Long •
(Axial only or oblique axial (limited •
Mobility •

15. Position /Gantry Dimension •
Laser beam •
Monitor in the room •
(IV (ureter, necrosis •
(Cooperation (apnea •
Needle guide •

16. (Needle extremity (same apnea •
(Coaxial System (No of samples •

17. Liver
Anterior abdomen

18. Liver
US
Rules: Pass through normal liver
Biopsy of the lesion’s wall
Needle retrieval during blocked expiration
(Ambulatory (outpatient
(Prevent shoulder pain after (20%

19. ……
Breast cancer – ovarian masses
Peritoneal carcinomatosis with -
ascites (cytology non
(contributive
?origin : type de cancer -

20. Pancreas
CT or US
Rules: Use the technique that best shows the lesion
alwaysAvois gastric puncture, otherwise 20G aspiration
sufficient
If suspected multicystic lesion avoid colon puncture
Risks: Hemorrhage by vascular injury
Acute pancréatitis if normal pancreas is injured
Passing through normal liver

21. US/CT

22. US/CT