A nephrostomy is performed whenever a blockage keeps urine from passing from the kidneys, through the ureter and into the urinary bladder. Without another way for urine to drain, pressure would rise within the urinary system and the kidneys would be damaged.
The most common cause of blockage necessitating a nephrostomy is cancer, especially ovarian cancer and colon cancer.
The goals of a kyphoplasty surgical procedure are designed to stop the pain caused by a spinal fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height due to the compression fracture. During kyphoplasty surgery, a small incision is made in the back through which the doctor places a narrow tube. Using fluoroscopy to guide it to the correct position, the tube creates a path through the back into the fractured area through the pedicle of the involved vertebrae. Using X-ray images, the doctor inserts a special balloon through the tube and into the vertebrae, then gently and carefully inflates it. As the balloon inflates, it elevates the fracture, returning the pieces to a more normal position. It also compacts the soft inner bone to create a cavity inside the vertebrae. The balloon is removed and the doctor uses specially designed instruments under low pressure to fill the cavity with a cement-like material called polymethylmethacrylate (PMMA). After being injected, the pasty material hardens quickly, stabilizing the bone.
Tunneled Central Venous Catheter
A tunneled central venous catheter is used when the:
- Person needs intravenous (IV) access so they can receive fluids, transfusions or drugs for a long period of time (generally longer than 3 months)
- Person needs many blood draws for lab tests. More blood draws can be done with a tunneled central venous catheter than with a peripherally inserted central catheter (PICC).
- Peripheral veins are not large enough for a PICC
- Small veins in the body can no longer be used for giving fluids or drugs
There are many benefits to having a tunneled central venous catheter rather than a regular IV. The most important benefit is that it reduces the number of needle sticks. However, it is important not to tell children that having a tunneled central venous catheter means they will never have to be “poked” again, since they may still need needle sticks for some blood tests.
A tunneled central venous catheter:
- Can remain in the vein for a long time
- Is very secure in the vein
- Reduces discomfort because the IV therapy can be given more easily
- Prevents the “burning” sensation sometimes felt when getting drugs by other IV methods
- The doctor makes 2 small cuts (incisions) in the skin. One cut is made over the vein where the catheter will enter the body. The other cut is made where the catheter will come out of the skin.
- The tip of the catheter is inserted in the large vein near the heart and threaded into or near the right atrium.
- The rest of the catheter is tunneled just under the skin and comes out on the chest or abdomen. There will be 15–25 cm (6–10”) of catheter outside the body.
- The doctor places a few stitches in the skin around the catheter to hold it in place.
- The incision over the vein is closed with a few stitches or pieces of tape.
- A dressing is placed over both incisions.
- A chest x-ray is done to confirm the catheter tip is in the correct position.
A Mediport consists of a reservoir compartment (the portal) that has a silicone bubble for needle insertion (the septum), with an attached plastic tube (the catheter). The device is surgically inserted under the skin in the upper chest or in the arm and appears as a bump under the skin. It requires no special maintenance and is completely internal so swimming and bathing are not a problem. The catheter runs from the portal and is surgically inserted into a vein (usually the jugular vein or subclavian veins). Ideally, the catheter terminates in the superior vena cava, just upstream of the right atrium. This position allows infused agents to be spread throughout the body quickly and efficiently.
An abscess is an infected fluid collection within the body. Percutaneous abscess drainage uses imaging guidance to place a thin needle through the skin into the abscess to remove or drain the infected fluid. It offers faster recovery than open surgical drainage.
Aspirations & Drainage Management
If a person is having ongoing and serious trouble swallowing and can’t get enough food or liquids by mouth, a G-Tube may be put directly into the stomach through the abdominal skin. (This procedure is called gastronomy). The tube allows feeding directly into the gastrointestinal tract to occur by bypassing the mouth and esophagus.
Examinations – Ultrasound
Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels.
Ultrasound examinations can help to diagnose a variety of conditions and to assess organ damage following illness.
Ultrasound is used to help physicians evaluate symptoms such as:
Ultrasound is a useful way of examining many of the body’s internal organs, including but not limited to the:
- heart and blood vessels, including the abdominal aorta and its major branches
- uterus, ovaries, and unborn child (fetus) in pregnant patients
- thyroid and parathyroid glands
- scrotum (testicles)
- brain in infants
- hips in infants
Ultrasound is also used to:
- guide procedures such as needle biopsies, in which needles are used to sample cells from an abnormal area for laboratory testing.
- image the breasts and guide biopsy of breast cancer (see the Ultrasound-Guided Breast Biopsy page.)
- diagnose a variety of heart conditions, including valve problems and congestive heart failure, and to assess damage after a heart attack. Ultrasound of the heart is commonly called an “echocardiogram” or “echo” for short.
- Most ultrasound scanning is noninvasive (no needles or injections).
- Occasionally, an ultrasound exam may be temporarily uncomfortable, but it is almost never painful.
- Ultrasound is widely available, easy-to-use and less expensive than other imaging methods.
- Ultrasound imaging is extremely safe and does not use any ionizing radiation.
- Ultrasound scanning gives a clear picture of soft tissues that do not show up well on x-ray images.
- Ultrasound is the preferred imaging modality for the diagnosis and monitoring of pregnant women and their unborn babies.
- Ultrasound provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as needle biopsies and fluid aspiration.