Fluid Aspiration and Drainage

This is a minimally invasive procedure in which we use imaging technologies (ultrasound or CT scan) to guide the placement of a needle into your child’s body to remove fluid that has collected abnormally, usually in her abdominal or chest cavities.

An interventional radiologist performs this procedure. These are physicians who have special training in performing minimally invasive, image-guided procedures in infants and children. In addition to the interventional radiologist, your child will be treated by a team of anesthesiologists, nurse practitioners, nurses, and technologists who specialize in caring for children.

We perform fluid aspiration and drainage in our suite on the second floor of Boston Children’s Hospital, which features three procedure rooms equipped with the latest imaging technology, a recovery area for patients who have received sedation or anesthesia, and examining rooms for outpatient visits.

When is this procedure needed?

Aspiration and drainage are usually recommended when fluid is collecting abnormally within your child’s body and is causing significant symptoms. Examples include large pleural effusions or empyemas (infected fluid around her lung) and abdominal abscesses.

How do I prepare my child?

Explain to your child in simple terms why the test is needed and what will happen. Tell your child you will be close by and that she may bring a favorite toy or blanket into the procedure room. Explain that she will receive medicine (sedation or anesthesia) to help lie still for the aspiration and drainage.

Your child’s doctor or nurse will tell you when your child must stop eating, drinking and taking medicine prior to the procedure.

What happens the day of the procedure?

• The interventional radiologist and/or the nurse practitioner will explain the procedure and answer your questions.
• You will be asked to sign a consent form. You must be your child’s legal guardian to sign this form.
• You and your child will be taken to the room where the procedure is done. You may stay until your child falls asleep. You will be escorted to a special waiting area.

What happens during the procedure?

• Your child is helped onto a table, where she will lie down.
• The radiology technologist cleans the area where the needle and/or drain are to be inserted with a special solution to help prevent infection. Sterile drapes are then placed.
• Using ultrasound or computed tomography (CT) for guidance, the interventional radiologist places a needle through the skin into the area where the fluid has collected. There may be some discomfort at this point, but it is minimized by the use of local anesthesia (numbing medication injected into the skin) and sedation medication.
• The radiologist will remove some of the fluid and send it for testing.
• A drain may be inserted and kept in place with a special dressing; a drainage bag will be attached.

What happens after the procedure?

Your child is transferred to the recovery room, where you may join her. A nurse will watch your child closely until it is safe for her to be discharged or to return to the hospital room. There may be some mild discomfort at the drain site.

How long will recovery take?

The healing process after fluid aspiration or drainage usually takes a few days. Sometimes there is mild pain at the site of the drainage tube. Pain medicine may be prescribed. An ice bag also may help. Your child will feel better after the fluid is drained but may need more treatment depending on the cause of the abnormal fluid. Your child will be followed closely by their doctor and the Interventional Radiology team until healing is complete. They may need more imaging before the drain is removed.

What are the risks associated with fluid aspiration and drainage?

When performed by an appropriately trained and experienced interventional radiologist, fluid aspiration and drainage is a safe technique. Like any other invasive procedure, certain complications and side effects can occur. These will be explained to you in detail before you give your consent.

Depending on the imaging technology used during the procedure, your child may be exposed to ionizing radiation (x-rays). We believe that the benefit to your child’s health outweighs the exposure that occurs during fluid aspiration and drainage. Because children are more sensitive to radiation exposure than adults, we have been leaders in adjusting equipment and procedures to deliver the lowest possible dose to young patients.

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