To review the imaging findings, indication criteria and the materials used in drainage technique. To describe the steps of procedure as well as the techniques involved in image guided drainage of post-surgical infected collection using the existing surgical drain.

Early post-operative period in high risk involving surgeries like Whipple's procedure, pancreatic necrosectomy, bariatric surgery and laparotomy is very vulnerable for complications especially post-operative collection Clinical features indicating complication after surgery include fever, abdominal pain and raised inflammatory markers CT is essential to diagnose post-operative collections especially to delineate the exact location of collection, so that an effective intervention can be planned accordingly through a safe access Image guided interventions are preferred over conventional surgical drainage for post-operative collections because of good patient compliance, cost...

The devices required for the procedure are (Fig. 1) 5 Fr vertebral/ KMP catheter 0.035'' hydrophillic wire Amplatz 260 cm exchange length stiff wire 12 Fr Ryle's tube We illustrate our technique of 'Drain within Drain' with the following case. A 62 year female patient was diagnosed with pancreatic head carcinoma on CT (Fig. 2) for which sheunderwent Whipple’s procedure . On post-operative day 8, she presented with abdominal pain, sepsis and deranged coagulation. CECT abdomen was performed which revealed a large walled off retroperitoneal...

'Drain within Drain' is a safe and cost-effective novel technique for draining difficult deep seated post-operative collections. It reduces the risks of solid organ/ visceral injury and bleeding complications. There were no complications in any of our cases during the procedure as well as post-procedure. This technique is preferred over direct percutaneous access techniques using drainage through major solid organs/ viscera.

P. Lenin; Chennai, TA/IN - Speaker at Apollo hospitals Chennai P. Chatterjee; Guwahati, ASSAM/IN - Consultant at Apollo hospitals Chennai R. Radhakrishnan; Chennai/IN - Consultant at Apollo hospitals Chennai

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