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Percutaneous Thoracic Drainage in Neonates: Catheter Drainage versus Treatment with Aspiration Alone¹

¹ From the Department of Radiology, the Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8. From the 2004 RSNA Annual Meeting. Received June 8, 2005; revision requested August 3; revision received August 19; accepted September 15; final version accepted, November 23. Address correspondence to R.M. (e-mail: ryan.margau{at}utoronto.ca).

View larger version (144K): [in this window] [in a new window] [Download PPT slide]   Figure 1a: Anteroposterior views from single-contrast upper gastrointestinal series in a male neonate (gestational age, 34 weeks) with recent repair of tracheoesophageal fistula. (a) View shows right pleural collection (empyema) communicating with the esophagus (black arrowhead). An 8-F All-Purpose drainage catheter (white arrow) was inserted with sonographic and fluoroscopic guidance. Surgically placed chest tube (white arrowhead) and internal jugular central venous catheter (black arrow) are present. (b) Follow-up view shows resolution of the esophageal leak.

View larger version (122K): [in this window] [in a new window] [Download PPT slide]   Figure 1b: Anteroposterior views from single-contrast upper gastrointestinal series in a male neonate (gestational age, 34 weeks) with recent repair of tracheoesophageal fistula. (a) View shows right pleural collection (empyema) communicating with the esophagus (black arrowhead). An 8-F All-Purpose drainage catheter (white arrow) was inserted with sonographic and fluoroscopic guidance. Surgically placed chest tube (white arrowhead) and internal jugular central venous catheter (black arrow) are present. (b) Follow-up view shows resolution of the esophageal leak.

View larger version (143K): [in this window] [in a new window] [Download PPT slide]   Figure 2a: Unenhanced transverse computed tomographic (CT) scans in male neonate (gestational age, 40 weeks) with CCAM of right lung. (a) Complex cystic lesion in right hemithorax with collapse of the right lung. (b) Resolution of pneumothorax and reexpansion of right lung after treatment with fluoroscopically placed 8-F All-Purpose drainage catheter.

View larger version (154K): [in this window] [in a new window] [Download PPT slide]   Figure 2b: Unenhanced transverse computed tomographic (CT) scans in male neonate (gestational age, 40 weeks) with CCAM of right lung. (a) Complex cystic lesion in right hemithorax with collapse of the right lung. (b) Resolution of pneumothorax and reexpansion of right lung after treatment with fluoroscopically placed 8-F All-Purpose drainage catheter.

View larger version (25K): [in this window] [in a new window] [Download PPT slide]   Figure 3a: Bar graphs show results of treatment with (a) catheter placement (n = 16) and (b) simple aspiration (n = 5). Black bar = successful treatment, gray bar = failed treatment.

View larger version (23K): [in this window] [in a new window] [Download PPT slide]   Figure 3b: Bar graphs show results of treatment with (a) catheter placement (n = 16) and (b) simple aspiration (n = 5). Black bar = successful treatment, gray bar = failed treatment.