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DOI:10.2214/AJR.07.4017
AJR 2009; 192:1085-1089
© American Roentgen Ray Society

Perspective

Fluoroscopic and Sonographic Guidance to Place Peritoneal Catheters: How We Do It

Ahmed K. Abdel-Aal1, Ajay K. Joshi1, Souheil Saddekni1 and Ivan D. Maya2

1 Department of Radiology, University of Alabama at Birmingham, 619 19th St. S, Birmingham, AL 35249-6830.
2 Department of Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL.

Abstract

OBJECTIVE. The purpose of this article is to detail a percutaneous approach to placing peritoneal catheters using sonographic and fluoroscopic guidance. Fluoroscopic-assisted placement of these catheters has been previously described in the literature. We emphasize the use of additional sonographic guidance, including color Doppler sonography, to determine the safest puncture site and to guide the initial needle puncture to avoid bowel perforation and injury to the epigastric artery.

CONCLUSION. Imaging-guided—that is, sonography plus fluoroscopy—percutaneous placement of peritoneal catheters is a safe, minimally invasive, and effective alternative to blind or open surgical placement. The use of sonographic guidance together with fluoroscopic assistance makes placement of peritoneal catheters a safer and effective alternative to blind or open surgical placement.

Keywords: chemotherapy • cirrhosis • dialysis • Doppler ultrasound • fluoroscopy • gene therapy • imaging guidance • intraperitoneal • ovarian cancer • peritoneal catheters • refractory ascites • renal disease • sonography


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