1. Biopsy results have a positive diagnosis rate between 70-100%. Performance is least for lymphoma biopsies. 2. Abdominal drainage procedures can be performed via direct puncture or the Seldinger technique using sterile materials including drains, fixation systems, and drainage bags. 3. After drainage procedures, the drain output is checked and patients are monitored for improvement before conducting clamping tests if drainage decreases and removing the drain. Follow up involves emptying and flushing the drain with saline.

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
1 drain Add
1 Fixation system 1 Puncture needle
1 3-way connector 1 guidewire
1 tubular connection 1 dilator
1 sterile urine bag
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. INTERVENTIONAL RADIOLOGY
CT
Advantages
anatomy•
Content•
Disadvantages
Long•
Axial only or oblique axial (limited)•
Mobility•

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

16. INTERVENTIONAL RADIOLOGY
US/CT
Needle extremity (same apnea)•
Coaxial System (No of samples)•

17. INTERVENTIONAL RADIOLOGY
US/CT
Liver
Anterior abdomen

18. INTERVENTIONAL RADIOLOGY
US/CT
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. INTERVENTIONAL RADIOLOGY
US/CT
Pancreas
CT or US
Rules: Use the technique that best shows the lesion
Avois gastric puncture, otherwise 20G aspiration
always 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