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Intracavitary contrast-enhanced ultrasound in ultrasound-guided percutaneous management of abdominal fluid collections/abscesses by a single clinician: an example of point-of-care ultrasound

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Abstract

Purpose

To assess the role of intracavitary contrast-enhanced ultrasound (IC-CEUS) as a focused ultrasound (US) examination aimed at supporting a single physician in the management of interventional procedures for abdominal fluid collections/abscesses.

Methods

In 43 patients (27 M/16 F, median age 68 years, range 35–91), a single physician performed catheter drainage (42) or needle aspiration (3) for the following: 14 infected abdominal fluid collections, 11 non-infected abdominal fluid collections, 9 pyogenic liver abscesses, 8 gallbladder empyema, and 3 infected pancreatic fluid collections. IC-CEUS (0.1–0.2 mL of SonoVue in 20 mL of saline) was carried out during catheter/needle placement and during the follow-up for catheters left in place.

Results

Immediate IC-CEUS allowed to verify the (1) correct positioning of the needle/catheter inside the target in all cases and (2) communication with adjacent structures so as to choose a proper treatment in 21% of the cases. Follow-up IC-CEUS aided in the management of 40 catheters left in place. Appropriate treatment was implemented in 19.3% of the cases because of the presence of biliary fistulas and gallbladder perforation. IC-CEUS helped the physician with the appropriate timing of catheter removal by providing information on catheter malfunction (due to obstruction/dislodgement) and the size of residual undrained cavities. No side effects were registered following IC-CEUS.

Conclusion

Even if not strictly performed at bedside, IC-CEUS may represent an example of point-of-care ultrasound since it allows an interventional clinician to assess needle/catheter placement success, make treatment decisions, and choose the optimal timing for catheter removal with low costs and without side effects.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Interventional Ultrasound Unit, Pineta Grande Hospital, SS Domitiana, KM 30,00, 81030, Castel Volturno, CE, Italy

    Giampiero Francica

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  1. Giampiero Francica
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Contributions

The author (GF) was the sole contributor to the study conception and design, material preparation, data collection and analysis, interpretation, literature research, and manuscript drafting and editing.

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Correspondence to Giampiero Francica.

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The author declare that they have no conflict of interest.

Ethical approval

This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the IRB of Pineta Grande Hospital who determined that our study did not need ethical approval. At the time of interventional procedures all patients signed an informed consent.

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Not applicable (information is anonymized and the submission does not include images that may identify the person). Not applicable (information is anonymized and the submission does not include images that may identify the person).

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Francica, G. Intracavitary contrast-enhanced ultrasound in ultrasound-guided percutaneous management of abdominal fluid collections/abscesses by a single clinician: an example of point-of-care ultrasound. J Ultrasound 23, 175–181 (2020). https://doi.org/10.1007/s40477-020-00467-6

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  • DOI: https://doi.org/10.1007/s40477-020-00467-6

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