Iatrogenic hepatic puncture while placing a peritoneal drain: percutaneous direct embolization under ultrasound guidance.

摘要

Different percutaneous techniques have been used to treat ascites, such as paracentesis, percutaneous catheter drainage, and permanent drain placement. Although these techniques are associated with low morbility rates, complications have been reported (1). We report a case of percutaneous embolization after a iatrogenic hepatic puncture while placing a peritoneal drain for malignant ascites,which was solved with immediate and direct embolization with the use of ultrasound (US) guidance. A 66-year-old woman with an ovarian cystadenocarci-noma came to the radiology department for placement of a temporary peritoneal catheter under US guidance. After informed consent was received and coagulation function was established, the patient was placed in a supine position and an insertion point was chosen on the right flank in view of the supramesocolic distribution of ascites. Local anesthesia (mepivacaine 1%) was instilled and an 8-F drainage catheter (Flexima regular all-purpose drainage catheter set; Boston Scientific, Natick, Massachusetts) was directly advanced via trocar technique into the peritoneal cavity under US guidance (Antares; Siemens, Erlangen, Germany).