USG-Guided Interventions

1.    Thoracocentesis—Chest tap—Pleural effusion tapping

2.    Paracentesis—Ascitic fluid tap

3.    Cyst aspiration

4.    Percutaneous abscess drainage

5.    FNAC/Biopsy—Breast, liver, kidney, lymph node, and any peripheral superficial structure

6.    Vascular access

7.    Suprapubic catheterization

ADVANTAGES

Real-time needle placement

Angled approach (different planes) possible

Color Doppler identifies and avoids the vascular structures in the path

Nonionizing

Minimally invasive with less morbidity

Readily available, relatively inexpensive, and portable

Less time-consuming

DISADVANTAGES

Not suitable for deeper, retroperitoneal structures

Hindrance by the bowel gas

Difficult access in obese patients

PREPROCEDURAL EVALUATION

Coagulation profile should be checked.

Informed written consent.

Prior USG to choose the short possible route, avoiding the adjacent crucial structures.

POSTPROCEDURAL EVALUATION

Monitor patient’s vitals

Reimaging for proper procedure

THORACOCENTESIS

Both diagnostic and therapeutic

Done in sitting or lateral decubitus position with the affected side up

Transducer should be perpendicular to the chest

Marker on the probe should point toward the head

Identify diaphragm, liver, spleen, and lung

Locate the largest pocket of fluid and mark it

Note the distance from the transducer to the pleural fluid

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