When puncture is not enough
Drainage is chosen when there is a large volume of fluid, with its rapid re-accumulation, with purulent pleurisy (empyema), when the contents are thick and cannot be evacuated through the needle, and with tension pneumothorax. The drainage is connected to a system that provides outflow and prevents air from flowing back in. The tube remains in place for several days until the lung expands and the discharge stops; All this time the patient is under observation. In case of empyema, the cavity is additionally washed through drainage.
Why is liquid removed?
The accumulation of fluid in the pleural or abdominal cavity has two sides. Firstly, it mechanically compresses the lung or abdominal organs, causing shortness of breath, heaviness and disruption of organ function - its evacuation brings immediate relief.
Secondly, the liquid itself is the most important diagnostic material. Its analysis determines the nature of the process: inflammation, tumor, heart failure, cirrhosis of the liver. Often it is the puncture examination that makes the final diagnosis.
Puncture or drainage
Puncture is a one-time removal of fluid with a needle. It is suitable for small volumes and for diagnostic purposes. Drainage is the installation of a tube that remains in the cavity for several days and ensures constant outflow. It is chosen for large volumes, purulent contents and rapid re-accumulation of fluid.
Safety of the procedure
The modern standard is to perform a puncture under ultrasound guidance: the doctor sees the exact location of the fluid, lung and diaphragm. This significantly reduces the risk of pneumothorax and organ damage compared to blind puncture. A limited volume is evacuated at once to avoid a sharp shift of the mediastinum and a drop in pressure.