Efficacy and safety of percutaneous image guided pigtail catheter drainage of thoracic and abdominopelvic fluid collection at Kenyatta National Hospital

Abstract

Background: Image guided percutaneous catheter drainage (PCD) allows minimally invasive drainage of thoracic-abdominopelvic fluid  collections and abscesses. This technique is an alternative to surgery with lower morbidity and mortality rates.

Broad Objective: To establish the efficacy and safety of image guided PCD of thoraco-abdominopelvic fluid collection.

Study Methodology: This was a prospective study conducted at Kenyatta National Hospital. All patients referred for image guided transthoracic/transabdominal fluid drainage were assessed for eligibility and recruited. The patient’s demographic data, clinical  presentation, image guided procedure details and outcome of the procedures were recorded. Statistical analysis was done using IBM  statistics, SPSS software (version 21).

Results: 73 adults were recruited in this study, 58.9% were female. This study recorded a 100%  technical success rate assessed by successful placement of the catheter into target collection. Majority of patients (69.8%) showed improvement within 24 hours of catheter placement. Radiological fluid clearance occurred after 24 hours in the majority (83.6%) of cases. Intra-procedural, pain was the commonest complication 71(97.3%) and one case of large bowel perforation was documented. In the  immediate postprocedural period 4.1% of patients developed mild symptoms of re-expansion pulmonary edema and 2.7% developed  mild symptoms of circulatory collapse following pleural and ascitic drainage respectively. The commonest short-term complication (up to  8 weeks) was catheter blockage.

Conclusion: Image guided PCD for thoracoabdominal fluid collection is a safe and efficacious treatment  technique with rapid improvement in patients’ symptoms. Minor complications including pain and catheter blockage can occur and  should be anticipated and adequately managed by clinicians.