Information for patients undergoing a CT-guided percutaneous drainage procedure

Introduction

This leaflet has been designed to answer some of the common questions you may have regarding your percutaneous drainage. This is the starting point for discussion about your treatment with the doctors looking after you, who wish to make sure you have received enough information about the procedure before signing the consent form.

Main text

A percutaneous drainage is a way of removing fluid, using a small tube (drain) through a tiny skin incision. This is usually performed to relieve the symptoms of the build-up of fluid such as ascites or infected collections. Some of this fluid may be sent off to be examined by a pathologist to gain further information about the nature of the fluid. The procedure is called “percutaneous” as it is done through the skin. The radiologist undertaking the procedure will use a CT scanner to guide the tube into the correct place.

How long will I be in the department?

The procedure itself will take approximately 30 minutes. However, you will have a period of bed rest of up to 6 hours afterwards. This will be confirmed when your appointment is booked.

What to do when you arrive

• Report to the Radiology Day Unit if you are attending as an Outpatient.
• If you are attending as an Inpatient, you will be allocated an appointment, and the X-ray porter will collect you in your bed to transfer to the CT Department.

Staff you are likely to meet

Radiologist

Radiographer

Radiology Nurse

Clinical Support Worker

Administration staff

Preparation for procedure/examination

Please contact the CT Department Reception on 01223 217426 if you:

• Have additional requirements that may require a longer appointment,
• Require a specific appointment time due to taking time sensitive medication (e.g. insulin, medicines for Parkinson’s disease),
• Are claustrophobic,
• Are pregnant,
• Require hospital transport,
• Are unable to lie flat,
• Have mobility issues,
• If you are taking any blood thinning medications, like Warfarin, Aspirin, Rivaroxaban, Dabigatran, Apixaban, Edoxaban, Clopidogrel or Ticagrelor you should inform your doctor before the procedure,
• Have any allergies you must inform your doctor,
• Weigh 150 kg or more.

Benefits

Other tests you have had have shown a collection of fluid. It may not be possible to determine what the fluid is from the previous test. If there is a lot of fluid it may be causing you discomfort that can be relieved by draining it. The fluid collection may also be a cause of infection which can be treated by draining it.

Risks

A percutaneous drainage is a very safe procedure, but as with any medical procedure there are some risks and complications that can arise.

The radiologist undertaking your drainage will explain the procedure and any potential complications before you sign a consent form.

What will happen on the day of my procedure/examination?

You may have some blood tests prior to the procedure to check you do not have an increased risk of bleeding.

You will then be asked to lie on the CT Scanner table in the position that the Radiologist has decided is most suitable. Your skin will be cleaned with antiseptic, and you may have some of your body covered with a sterile sheet. The Radiologist will use the CT Scanner to decide on the most suitable point for inserting the needle and drain tubing.

Your skin will be then anaesthetised, and the drain tubing inserted into the area of the collection fluid.

Most drainage procedures do not hurt, however, may be painful if there is inflammation present around the collection being drained. The local anaesthetic used to anesthetise the skin will sting to start with, but this will soon pass as the skin and deeper tissues become numb. You may be aware of a pressure sensation as the needle and drain tubing passes into the deeper tissues, but this is usually well tolerated.

The procedure may take approximately 30 minutes, although you will be in the department for a longer period to ensure there have been no complications.

The drainage tubing will be connected to a small bag where the fluid will collect.

This can be fastened to clothing or bed if required.

Accessibility requirements

If you require support for your appointment, e.g. if you find it hard to hear, see or be understood by others, please let the receptionist or healthcare professional know on arrival or contact us by email: or telephone: 01223 256998.

Medication

Bring all of your medicines (including inhalers, injections, creams, eye drops or patches) and a current repeat prescription from your GP.

Can I bring someone with me?

Those accompanying you will be required to stay out of the examination room during the procedure and remain in the waiting area.

Childcare whilst in department

Staff are unable to look after or supervise children whilst your procedure/examination is taking place. Please make alternative arrangements for the care of your children whilst you attend for your procedure/examination. If you attend an appointment with children with no one to look after them whilst you have your examination/procedure, then your appointment will unfortunately have to be cancelled and rescheduled.

Personal belongings

These would preferably be left on the ward or in the Radiology Day Unit but can be brought down to the department if necessary – they will be kept in the room during the procedure

What happens after my procedure/examination?

You will be asked to stay in bed for a few hours until you have recovered. A nurse will carry out routine observations, such as taking your pulse and blood pressure, to make sure there are no problems. If you have any pain following the procedure, we may give you some pain-relief medication.

Possible side effects and additional aftercare

If you feel unwell after your procedure, you should seek medical advice from your GP/ hospital doctor or through the emergency department and inform them that you have had a drainage procedure.

You will be given an information sheet before you are discharged.

How, when and by whom will my results be communicated?

Your referring team or clinician will be responsible for communicating reports back to you.

Test results are made available via MyChart but there is 3 week delay from when an examination has been reported to when it is available on MyChart, in order to allow time for your clinical team to be able to see and action the results prior to them being released to the individual patient.

Are there any alternative tests?

If you are unable to have the drainage procedure under CT guidance it may be performed under Ultrasound.

Contacts/Further information

Please contact the CT Department on 01223 217426.

Question, concern or complaint?

Firstly, speak to your nurse, doctor or other staff member as soon as you can so they can do their best to put things right straightaway.

If you don’t feel able to speak directly to the people caring for you, contact the patient advice and liaison service (PALS). Please call 01223 216756 9am to 4pm Monday to Friday, email the CUH PALS Team or via a form available via link on the CUH PALS webpage.

PALS is open every weekday, and you can leave a message in the evenings and weekends.

MyChart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on the MyChart section of our website.