Purpose
Percutaneous haematoma drainage is a common procedure performed by radiologists. Haematomas commonly occur secondary to trauma, supratherapeutic anticoagulation, or iatrogenic causes, such as post-operative complication.
Clinicians may request a haematoma drainage to be performed by radiology for various clinical reasons, including pain, compression of adjacent anatomical structures causing symptoms, or the suspicion of superimposed infection.
While these procedures are generally safe, there are also associated risks, and therefore it is important to understand the benefits of performing the procedure.
In this retrospective study, we aim...
Methods and materials
The retrospective audit included patients who fit the inclusion criteria who had a radiologically drained haematoma over the past 10 years at our tertiary center. Inclusion criteria included patients over the age of 18 years old, the description of the drained collection mentioning blood products, and the method of drainage using either ultrasound or computed tomography (CT).
Patients were identified through a retrospective search of the Alfred Health REASON Cohort Discovery Platform, searching for radiology report text indicating ‘haematoma’ as well as ‘ultrasound or computed...
Results
The search criteria yielded 224 patients, of these, 130 patients were confirmed to have undergone a radiologically guided haematoma drainage. 121 of these were performed under ultrasound guidance and 9 under CT guidance.
Post-operative iatrogenic haematomas were the most common reason for a drainage request, accounting for 55.4% of cases (Fig. 1), while lower limb haematomas were the most common body region, representing 29.2% of cases (Fig. 2).
Needle aspiration was the most common method of drainage, accounting for 64.6% of drainages, while a catheter/drain...
Conclusion
The outcomes of percutaneous haematoma drainages are overall favorable. Careful patient selection and method of drainage can help to improve the rate of success.
Drainages also provide useful information to clinicians regarding the nature of the collection, including the presence of a superimposed infection, to help guide future clinical management.
References
Johnson, M. Kohi, N. Fidelman et al. Hematomas - to drain or not to drain, the interventionalist’s dilemma. JVIR. Volume 24 Issue 4. Supplement. S57. DOI:https://doi.org/10.1016/j.jvir.2013.01.133.
Shikhman A, Tuma F. Abdominal Hematoma. [Updated 2021 Apr 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 January-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519551
Trujillo L, Naranjo S, Cardozo A, Alvarez B. Ultrasound-guided percutaneous drainage of a traumatic abdominal wall hematoma in the emergency department. World J Emerg Med. 2012;3(4):308-310. doi:10.5847/wjem.j.issn.1920-8642.2012.04.013