USG-Guided Diagnostic & Therapeutic Procedures
USG-Guided Diagnostic & Therapeutic Procedures
USG-guided (Ultrasound-guided) diagnostic and therapeutic procedures offer a safe, accurate, and minimally invasive approach to diagnosing and treating a wide range of medical conditions. Using real-time ultrasound imaging, physicians can precisely visualize internal organs, soft tissues, joints, and fluid collections, ensuring greater accuracy and improved patient outcomes.
These procedures are commonly used for biopsies, aspirations, fluid drainage, injections, and targeted treatments, allowing clinicians to reach the exact area of concern while minimizing discomfort and reducing complications. Ultrasound guidance eliminates radiation exposure, making it a preferred choice for repeated evaluations and procedures.
Types of USG-Guided Diagnostic & Therapeutic Procedures
Pleural Tapping (Thoracentesis)
Diagnostic: Analyze pleural fluid (infection, malignancy, CHF, etc.)
Therapeutic: Relieve dyspnea from pleural effusion
Indications:
Moderate-to-large pleural effusion
Unexplained fluid accumulation
Procedure:
Position patient upright or lateral decubitus
Identify fluid pocket with USG
Aseptic prep, local anesthesia
Needle insertion under real-time USG guidance
Aspirate fluid
Complications: Pneumothorax, bleeding, infection
2. Ascitic Tapping (Paracentesis)
Purpose:
Diagnostic: Ascitic fluid analysis (cirrhosis, malignancy, infection)
Therapeutic: Relief of tense ascites
Indications:
Symptomatic ascites
Unexplained fluid accumulation
Procedure:
Patient supine or semi-recumbent
Identify fluid with USG
Aseptic prep, local anesthesia
Needle insertion under USG guidance
Drain fluid
Complications: Bleeding, infection, bowel injury, hypotension (rapid drainage)
3. Pigtail Catheter / Intercostal Drain (ICD) Insertion
Purpose:
Continuous drainage of pleural effusion, pneumothorax, hemothorax, or empyema
Indications:
Moderate-to-large pleural effusion
Pneumothorax requiring drainage
Empyema
Procedure (Seldinger technique):
Identify safe entry site using USG
Aseptic prep, local anesthesia
Needle puncture → guidewire → tract dilation → catheter placement
Confirm position with USG or X-ray
Connect to drainage system
Complications: Malposition, bleeding, infection, organ injury
4. Abscess Drainage (Intra-abdominal, Liver, Soft Tissue)
Purpose:
Drain purulent collections, reduce infection
Indications:
Symptomatic abscess confirmed by imaging
Failure of medical therapy
Procedure:
Localize abscess with USG
Plan safest tract avoiding vessels, bowel, pleura
Aseptic prep, local anesthesia
Needle puncture → aspirate pus → place catheter if continuous drainage needed
Monitor output and follow-up imaging
Complications: Bleeding, injury to surrounding structures, catheter blockage, secondary infection