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Drainage of the Multiloculated Collection 

Drainage of the Multiloculated Collection
Chapter:
Drainage of the Multiloculated Collection
Author(s):

Mikin V. Patel

, and Steven Zangan

DOI:
10.1093/med/9780199986071.003.0099
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date: 29 July 2021

Percutaneous drainage of an abscess is the standard of care and significantly improves patient outcomes. Typically, either trocar or Seldinger technique is used to access the abscess under ultrasound or computed tomography guidance. Pre-procedural planning is the most important step of the procedure, with the goal of using a safe, direct, short route to the collection. Vital anatomic structures such as sizeable arteries, solid organs (with a few exceptions), or a hollow viscus such as the stomach or colon should be avoided. Placement of a drain must balance effective positioning with a safe anatomic window for access. A multiloculated collection presents a special challenge because only one safe catheter approach may be available. In these cases, catheters with multiple side holes or multiple loops can be used to access the separate isolated components. Tissue plasminogen can also be utilized to break down the loculations and improve drainage.

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