bda23054
Networker
POSTOPERATIVE DIAGNOSIS
Diverticular abscess.
NAME OF OPERATION
CT-guided drainage of a diverticular abscess.
INDICATIONS
This is a 70-year-old male who originally presented with free air on CT scan, which showed a diverticular perforation. The patient clinically was doing better but did not have complete resolution of symptoms, so the patient had a repeat CT scan, which showed air fluid levels and a new diverticular abscess so the patient was brought for CT-guided percutaneous drainage of abscess.
DESCRIPTION OF OPERATION
The patient was seen in the CT suite, placed in the prone position. Scout films were taken showing the area of concern. A radiopaque marker was placed on the buttock and films again taken showing the planned trajectory of the needle into the cavity. This area was then marked, the radiopaque marker was removed and the skin was prepped and draped in the usual sterile fashion, injected with 1% lidocaine plain into skin, subcutaneous tissues and deep into the pelvis. The needle was left in place and films were taken again showing proper trajectory of the needle into or near the abscess. The needle was then removed. A 6-French Huey catheter, 10 cm in length, was then inserted in the same direction as the anesthetic needle. Films were taken, CT guidance was used throughout the procedure. It was entered into the abscess cavity. Approximately 150 mL of purulent, foul-smelling liquid was removed and sent for culture. CT scan was taken with the needle left in place and almost 98 to 99% resolution of the abscess. The needle was then slowly removed and the patient was allowed to lay prone and then one final set after the needle was removed CT scan was taken showing again 98 to 99% resolution of this abscess. A Band-Aid was placed on the incision.
Diverticular abscess.
NAME OF OPERATION
CT-guided drainage of a diverticular abscess.
INDICATIONS
This is a 70-year-old male who originally presented with free air on CT scan, which showed a diverticular perforation. The patient clinically was doing better but did not have complete resolution of symptoms, so the patient had a repeat CT scan, which showed air fluid levels and a new diverticular abscess so the patient was brought for CT-guided percutaneous drainage of abscess.
DESCRIPTION OF OPERATION
The patient was seen in the CT suite, placed in the prone position. Scout films were taken showing the area of concern. A radiopaque marker was placed on the buttock and films again taken showing the planned trajectory of the needle into the cavity. This area was then marked, the radiopaque marker was removed and the skin was prepped and draped in the usual sterile fashion, injected with 1% lidocaine plain into skin, subcutaneous tissues and deep into the pelvis. The needle was left in place and films were taken again showing proper trajectory of the needle into or near the abscess. The needle was then removed. A 6-French Huey catheter, 10 cm in length, was then inserted in the same direction as the anesthetic needle. Films were taken, CT guidance was used throughout the procedure. It was entered into the abscess cavity. Approximately 150 mL of purulent, foul-smelling liquid was removed and sent for culture. CT scan was taken with the needle left in place and almost 98 to 99% resolution of the abscess. The needle was then slowly removed and the patient was allowed to lay prone and then one final set after the needle was removed CT scan was taken showing again 98 to 99% resolution of this abscess. A Band-Aid was placed on the incision.