Percutaneous catheter drainage of infected and noninfected hematomas: Results and recommendations

Controversy exists regarding the feasibility of and indications for percutaneous drainage of hematomas. Indications for drainage in 50 patients included infected hematoma, a large hematoma in a septicemic patient, pressure symptoms, and obstructive signs. Small or nonsymptomatic collections are not drained. Hematomas may be liquefied and easily drained, or they may be organized and more difficult to drain. The latter hematomas appear echogenic or septated on US and have a high density on CT. MR imaging evaluation of these patients reveals short T1 and T2 relaxation times and high signal intensity. A pitfall in management of hematomas is confusion with unsuspected tumors. This has occurred in five patients, and required eventual biopsy. Poor drainage is an indicator. Number 12- to 14-French sump systems are used for drainage, and frequently multiple catheters are required