Abscess Drainage

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This procedure is performed to remove an abscess – an infected collection of fluid in the body. An abscess can occur anywhere in the body but typically involves the abdomen and/or the skin surface. An abscess is most often is caused by recent surgery or as a result of another body infection such as appendicitis. A person with an abscess will usually suffer from pain in the location of the infection, chills and fever. To remove the abscess, a doctor uses image-guided technology, such as CT scans, to insert a catheter – a long, thin tube – into the infected area and drain the fluid. Most often a drainage tube is left inside until all the fluid has drained and the infection is resolved. In most cases, an abscess drainage can be successfully completed with this minimally invasive technique however there are a small percentage of patients who need further intervention in an operating room.

Need to Know

Nice to Know
  • Do not eat or drink anything at least eight hours before the procedure
  • If you take blood thinners, talk to your doctor beforehand about adjusting or stopping this medication
  • Do not take aspirin or other pain relievers, such as Ibuprofen, for five days before the procedure
  • If you have diabetes, ask your primary care doctor about adjusting your insulin dose
  • Tell your technologist about any allergies, especially to local or general anesthetics and contrast materials (“x-ray dye”)
  • Inform your technologist if you are pregnant
  • You’ll be given a gown to wear during your treatment
  • You may feel some pressure when the catheter is inserted but no serious discomfort
  • Plan to stay overnight after your procedure
  • This treatment is a minimally invasive alternative to conventional surgery
  • No surgical incision is needed, just a small nick in the skin
  • You may feel some discomfort after the procedure, but no serious pain

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How Does It Work?

Using image-guided technology, such as CT scan, a doctor inserts a small catheter into the affected area and drains the fluid. Often the catheter is connected to a drainage bag outside of your body to collect the fluid until it has drained.

What Happens — Before, During, and After?

The morning of your procedure, you’ll be admitted to Hartford Hospital. When you arrive at the Radiology Department, a nurse will greet you and let the team know you’ve arrived. Before the procedure, you may have an ultrasound, CT, or MRI exam.

As the time for your procedure nears, the nurse will bring you to a pre-procedure holding area, and ask you to change into a gown. You’ll sit on a bed.

Your doctor will greet you, explain the procedure, and answer any questions you may have. A technologist or nurse will wheel your bed into the procedures room, and you’ll be positioned on the examining table. The technologist or nurse will connect monitors for your heart rate, blood pressure, and pulse, and an intravenous (IV) line will be inserted into a vein in your hand or arm. This will be used to give you sedatives during the procedure. Some patients receive general anesthesia, but in most cases, this is not necessary.

The technologist will shave, sterilize, and cover the area of your body where a catheter will be inserted with a surgical drape. The area will then be numbed using a local anesthetic. The radiologist will make a very small nick, and you may feel some pressure as the catheter is inserted, but you won’t feel any serious discomfort. Using image-guidance, the catheter will be manipulated to the abscess, allowing for drainage of the infected fluid. Depending on the complexity of your case, this procedure can take roughly 20 minutes to an hour.

When the procedure is complete, your intravenous line will be removed.

If needed, the catheter may be connected to a drainage bag outside of your body. The tube will remain in place until the fluid has drained and your infection is gone. It may take several days to drain the abscess.

Most patients feel some discomfort after the procedure. Medications can be given to control pain. You may also experience mild nausea or a low-grade fever. You will most likely spend a few days at Hartford Hospital. Once you are sent home, further follow-up with your doctor is usually needed to monitor your healing and make sure that any infection is gone. Once your doctor has concluded that all the fluid is gone and the infection has resolved, the catheter is removed. This is usually done in the doctor’s office.

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How Should I Prepare?

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. For example, you may want to arrange to have someone drop you off on the day of your procedure and pick you up after your hospital stay – usually a few days. You might like to keep a list of questions or — as you’re doing now — educate yourself about the procedure.

Another important part of your preparation will be guided by your doctor:

  • You will need to have an image study done, such as a CT scan, X –ray or ultrasound, to give your doctor a good picture of what is going on inside the infected area.
  • Your doctor may also request an EKG.
  • Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin or warfarin) for a time before the procedure.

Some of your preparation will need to be timed to the procedure:

  • Five days before the procedure, stop taking vitamin E.
  • The day before the procedure (or the Friday before, if you're scheduled for a Monday procedure), a nurse from the Interventional Radiology Department will call you. The nurse will give you any additional instructions, and will ask if you have any questions.
  • In the 8 hours before the procedure, do not eat food.
  • Up to 2 hours before you arrive at the hospital, you may drink clear liquids. Black coffee or tea are fine, but do not add cream or milk. You may sip water with medications.
  • When you arrive, make sure the nurse and radiologist know about any allergies you may have, especially allergies to local anesthetics (such as lidocaine), general anesthetics (such as propofol), or X-ray dye (contrast media). If there's any chance you may be pregnant, tell your radiologist.
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What Should I Bring?

You may want to invite a family member or friend to accompany you to your procedure.

Some of the things that you might consider taking include:

  • A 24 hour supply of any medications you may be taking.
  • A list of these medications, including the dosage and usual times you take each.
  • You may want to take personal care items, such as your own toothbrush, toothpaste, soup, lotion, and hair care products.
  • Comfortable, loose-fitting clothes.
  • Comfortable shoes.
  • You may want to bring a book, magazine, or eReader to pass the time.
  • Avoid bringing jewelry or valuables.
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What Are the Benefits and Risks?

The benefits of minimally invasive abscess drainage could be:

  • No surgery is needed and there is no scarring
  • Recovery from this procedure is typically short with less pain than a surgical drainage performed in the operating room

Risks you should be aware of include:

  • As with any procedure, there is a small risk of infection. The chance of infection requiring antibiotic treatment is less than one in 1,000.
  • There is a very slight risk of an allergic reaction if contrast material is injected.
  • Very rarely, a nearby organ may be damaged.
  • Occasionally bleeding may occur
  • The catheter placed at the time of abscess drainage may become blocked or displaced requiring movement or changing of the catheter
  • In some cases a very large or complex fluid collection may require more than one abscess drain

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.

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