Image-guided drainage of an abscess or fluid (Image-guided percutaneous drainage)

A minimally invasive procedure in which an interventional radiologist uses a scan to guide a thin tube through a small skin puncture to drain an abscess or a collection of fluid.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

It drains an abscess or fluid collection through a small skin puncture under image guidance — minimally invasive, not open surgery, so no surgical scar.
It relieves pressure and helps control infection, but may not fix the underlying cause, which can still need antibiotics or further treatment.
A drain is often left in for hours or days; many people stay in hospital while it works.
It is usually safe and effective, but carries small risks of bleeding, spreading infection and injury to nearby structures — done by a skilled interventional radiologist.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeMinimally invasive image-guided procedure

AnaestheticLocal anaesthetic, sometimes with sedation

How long it takesAbout 30–60 minutes

Hospital stayOften inpatient, especially if you are unwell or a drain stays in; sometimes day case

Time off workVaries; depends on the underlying problem and whether a drain remains

When you'll see resultsFluid is removed straight away; the collection settles over days as it drains

On the NHS?Routinely done on the NHS, often as urgent or emergency care; private access is less common

A general guide. Your radiologist will give you advice for your situation.

Best fit

Removes infected or unwanted fluid, relieving pressure and pain

Pause if

There is no safe path to the collection without crossing bowel, major vessels or other organs.

Main recovery point

You are monitored for bleeding and for signs that disturbing the collection has stirred up infection. Pain at the site is managed with simple pain relief.

Good aftercare

Clear written instructions on drain care, warning signs and who to contact.

First hours

You are monitored for bleeding and for signs that disturbing the collection has stirred up infection. Pain at the...

First 1–3 days

If you had an infected collection, you often start to feel better as it drains and antibiotics work. The drain...

While the drain is in

The drain is flushed and cared for to keep it working. You may stay in hospital or, in some cases, go home with...

Drain removal

When output falls and scans or tests show the collection has settled, the drain is removed — usually a simple...

Medical line illustration of an ultrasound probe scanning beneath the skin for Image-guided drainage of an abscess or fluid. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is image-guided drainage of an abscess or fluid?

An abscess is a pocket of infected fluid (pus); other collections can be blood, bile, urine, lymph or simple fluid that has built up where it should not. Image-guided drainage removes that fluid through a thin tube, called a drain or catheter, placed through a small puncture in the skin.

It is carried out by an interventional radiologist, who uses a scan — usually ultrasound or CT — to see the collection and guide the tube precisely into it while avoiding nearby organs and blood vessels. Because it works through a small skin puncture under local anaesthetic, rather than an open operation, it is described as minimally invasive: there is no large surgical cut and no surgical scar.

Draining an infected collection relieves pressure and pain and lets antibiotics work better; it is often a key step in getting an infection under control. The drain may be taken out at the end if all the fluid is removed, or left in for hours or days so the collection keeps emptying.

Drainage treats the collection, but it does not always treat the cause. Depending on what led to the collection, you may still need antibiotics, further tests, or treatment of an underlying problem such as a bowel issue. Your team should explain how drainage fits into your overall care.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Ultrasound-guided drainage

Used when the collection can be seen clearly on ultrasound and reached safely from the surface, for example some collections in the abdomen, pelvis or soft tissues.

CT-guided drainage

A CT scanner gives detailed guidance for deeper or harder-to-reach collections, helping the radiologist avoid bowel, blood vessels and organs.

Aspiration only

For a small or simple collection, the radiologist may simply draw the fluid off with a needle and not leave a drain in.

Catheter drainage

For larger or infected collections, a thin tube is left in place and connected to a bag so the collection keeps draining over hours or days.

Drainage with fluid testing

Fluid removed is often sent to the laboratory to identify infection and guide the right antibiotics.

Image-guided drainage vs open surgical drainage

Point	Image-guided drainage	Open surgery
Access	Small skin puncture	Surgical cut
Anaesthetic	Usually local ± sedation	Often general
Recovery	Usually quicker	Usually longer
When preferred	Most reachable collections	If drainage fails or unsafe

Image-guided drainage is often the first choice for reachable collections. Surgery may be needed if there is no safe path, drainage fails, or the underlying cause needs an operation.

Preparing for your procedure

Tell the team about all medicines, especially blood thinners (warfarin, apixaban, rivaroxaban, clopidogrel), which usually need pausing.
A blood test to check clotting is often done first, particularly for deep collections.
Mention any allergies, including to local anaesthetic or X-ray dye if CT is used.
Tell them if you are or might be pregnant, especially if CT guidance is planned.
You may be asked not to eat for a few hours beforehand, particularly if sedation is planned.
Antibiotics are often given around the time of the procedure.
Arrange support at home in case you are discharged with a drain still in place.

What happens

You are positioned so the radiologist can see the collection on the scan. The skin is cleaned and local anaesthetic is injected to numb the area, which stings briefly. Sedation may be offered to help you relax.

Using ultrasound or CT for guidance, the radiologist passes a needle through the skin into the collection, then places a thin tube (catheter) over a guidewire into the right spot. Fluid is drawn off and a sample is usually sent to the laboratory. You may feel pressure or some discomfort as the tube goes in.

If a drain is left in, it is stitched or fixed to the skin and connected to a collection bag. There is a small skin puncture rather than a surgical cut, so there is no large wound or surgical scar. The procedure usually takes about 30 to 60 minutes. Many people stay in hospital afterwards, especially if they are unwell or the drain remains in place.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

There is no safe path to the collection without crossing bowel, major vessels or other organs.
You have a bleeding tendency or take blood thinners that cannot be safely paused or corrected.
The collection is too small, solid or scattered to drain effectively with a tube.
The underlying problem clearly needs surgery rather than drainage.
You could not tolerate or lie still for the procedure even with sedation.

Delay or rearrange if…

Your blood thinners or a clotting problem have not yet been reviewed.
You are or might be pregnant and CT guidance is planned (unless drainage is urgent).
Key scans needed to plan a safe route are missing.
The collection is not yet mature enough to drain well, and a short wait is safer.
There is a more urgent problem that needs dealing with first.

Alternatives to discuss

Antibiotics alone for some small collections that may settle without drainage.
Open or keyhole surgical drainage if there is no safe percutaneous route or drainage fails.
Repeated aspiration rather than a long-term drain in selected cases.
Treating the underlying cause directly where that is the priority.
Watchful waiting with repeat scans for very small, non-infected collections.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

Local anaesthetic

Standard for image-guided drainage; numbs the skin and tissue along the tube's path.

Sedation

Often offered alongside local anaesthetic to help you relax for a more uncomfortable or longer drainage.

Benefits

Removes infected or unwanted fluid, relieving pressure and pain
Helps bring infection under control and lets antibiotics work better
Minimally invasive, through a small skin puncture rather than open surgery
Usually done under local anaesthetic, often avoiding a general anaesthetic
Allows the fluid to be tested so the right antibiotics can be chosen
Often a quicker recovery than open surgical drainage

Risks & complications

More common

Discomfort or pain at the puncture and drain site
Some bruising or minor bleeding at the skin puncture
The need to keep a drain in for hours or days, which can be inconvenient
The drain blocking, leaking or coming out and needing adjustment or replacement

Less common

Infection spreading into the bloodstream (bacteraemia), which can make you feel unwell with fever
More significant bleeding, especially if clotting is abnormal or near blood vessels
Failure to fully drain the collection, needing a repeat procedure or surgery
The collection coming back after the drain is removed

Rare but serious

Septic shock, a serious whole-body reaction to infection
Injury to a nearby organ, bowel or blood vessel as the tube is placed
Heavy bleeding needing transfusion or a further procedure

The most important risks are bleeding, the infection spreading into the bloodstream as the collection is disturbed, and rare injury to a nearby organ. These depend on where the collection is, how unwell you are and your clotting. Make sure your blood thinners have been reviewed, and watch for signs of worsening infection such as high fever, shivering or feeling very unwell, which need urgent attention.

Published figures to discuss

Rates depend on the site of the collection, how unwell the patient is and their clotting, so they vary between studies. Technical success is usually high; major complications are uncommon but include infection entering the bloodstream and bleeding.

Figure	Reported range	How to interpret it	Source / confidence
Bacteraemia (infection in the bloodstream)	Reported in around 2–5% of drainage procedures	Disturbing an infected collection can release bacteria; you are monitored for fever and feeling unwell.	Complications of percutaneous fluid drainage — PMC reviewpmc.ncbi.nlm.nih.govPublished figure
Septic shock	Reported in around 1–2% in some series	A serious whole-body response to infection needing urgent treatment.	Complications of percutaneous fluid drainage — PMC reviewpmc.ncbi.nlm.nih.govPublished figure
Technical success of drainage	Generally high, often above 90% for reachable collections	A small proportion fail to drain fully and need a repeat procedure or surgery.	Complications of percutaneous fluid drainage — PMC reviewpmc.ncbi.nlm.nih.govPublished figure

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

How you recover depends on why the collection formed and whether a drain stays in. Many people feel better quite quickly once an infected collection is drained, but you may remain in hospital while the drain does its work and antibiotics take effect.

First hours

You are monitored for bleeding and for signs that disturbing the collection has stirred up infection. Pain at the site is managed with simple pain relief.

First 1–3 days

If you had an infected collection, you often start to feel better as it drains and antibiotics work. The drain output is checked regularly and the fluid may be tested.

While the drain is in

The drain is flushed and cared for to keep it working. You may stay in hospital or, in some cases, go home with the drain and instructions on how to look after it.

Drain removal

When output falls and scans or tests show the collection has settled, the drain is removed — usually a simple, quick process at the bedside or clinic.

After removal

The small puncture site heals over. You may need ongoing antibiotics or treatment of the underlying cause, and a follow-up scan to confirm the collection has not returned.

What's normal — and not a worry

Soreness around the puncture and drain site
Feeling gradually better as an infected collection drains
A drain bag collecting fluid that changes in amount and appearance over days
Tiredness while recovering from the infection itself
A small puncture mark that heals after the drain comes out

Aftercare

Look after the drain as instructed — keep it secure, clean and draining freely if you go home with one.
Take antibiotics exactly as prescribed and complete the course.
Keep the puncture and drain site clean and dry, and watch for redness or leaking.
Use simple pain relief for soreness at the site.
Restart blood thinners only when and as the team advises.
Attend any planned scan or review to confirm the collection has settled.
Keep contact details for the team in case the drain blocks, falls out or you feel unwell.

Before your procedure

Clear instructions on caring for a drain if going home with one
Antibiotic course collected and understood
When to restart blood thinners confirmed
Simple pain relief at home
A follow-up scan or review arranged
List of urgent warning signs saved
Ward or out-of-hours contact number saved

Scars and how they heal

Drainage is done through a small skin puncture rather than a surgical cut, so it does not leave a large surgical scar. Where a drain is left in, it is fixed to the skin and, once removed, the small puncture site usually heals to leave only a tiny mark. There may be some bruising or soreness around the site for a while.

⚠ Get urgent help if…

High fever, shivering or feeling very unwell after the procedure (possible spreading infection) — seek urgent help
Severe or worsening pain at the site or in the area drained
Heavy or continuing bleeding from the puncture site, or feeling faint and dizzy
The drain falling out, blocking, or leaking large amounts around the site
Spreading redness, swelling or pus at the drain site
Feeling breathless, with a fast heartbeat or confusion (possible serious infection) — call 999

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your radiologist gives you.

Results & realistic expectations

A good result is that the collection drains, pressure and pain ease, and any infection comes under control, often with you feeling noticeably better within a day or two. Testing the drained fluid can pinpoint the infection and guide the right antibiotics.

Drainage treats the collection rather than always its cause. Some collections come back, or there is a deeper problem — such as a leak from the bowel — that still needs treating. A follow-up scan is often used to confirm the collection has settled, and your team should explain whether any further treatment is needed.

How long it lasts

Once a collection is fully drained and the cause is dealt with, it often does not return. But if the underlying problem persists, the collection can reform and need draining again or a different treatment. Your team may arrange a follow-up scan to check, and will treat any underlying cause to reduce the chance of it coming back.

Related tests, treatments or support

Drainage is usually combined with antibiotics and with tests on the drained fluid, and is often part of treating a wider problem such as appendicitis, diverticulitis, a post-surgical complication or another infection. Sometimes drainage is used to settle an infection first, with surgery to deal with the underlying cause planned for later.

Follow-up & long-term care

You will usually be reviewed while the drain is in and around the time it is removed, often with a scan to confirm the collection has settled. You should be told who is responsible for your ongoing care, how the underlying cause will be treated, and who to contact if the drain has problems or symptoms return.

Care for the drain daily as instructed if you go home with one
Complete the full course of any antibiotics
Attend the follow-up scan to confirm the collection has resolved
Report promptly if symptoms of infection return

Repeat, follow-on and what comes next

A drain may need repositioning, flushing or replacing if it blocks or stops draining.
Some collections do not fully drain and need a second procedure or surgery.
A collection can recur if the underlying cause is not treated, needing further drainage.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

Clear written instructions on drain care, warning signs and who to contact.
A specific plan for any antibiotics and for restarting blood thinners.
A follow-up scan or review to confirm the collection has resolved.
A named team responsible for treating the underlying cause.
An urgent-care route for fever, bleeding or a drain problem.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Which imaging is used to guide the drainage (ultrasound or CT)
Whether a drain is left in place, and for how long it needs care
The complexity and location of the collection
Laboratory testing of the drained fluid and any antibiotics
The length of any hospital stay needed
Follow-up scans and review to confirm the collection has settled

Make sure your written quote includes

The interventional radiologist's fee and who will perform the procedure
The imaging and facility fee
Whether any hospital stay and drain care are included
Laboratory fees for testing the fluid
Follow-up scans and reviews to confirm resolution
What happens, and what it costs, if the collection needs draining again or surgery
The cancellation policy and cover if a complication occurs

On the NHS? Image-guided drainage is a routine NHS procedure and is frequently part of urgent or emergency care; private access is less common because it often forms part of acute treatment.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the radiologist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the radiologist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good radiologist will welcome every one of these.

What caused this collection, and will draining it treat the cause as well?
Will a drain be left in, and if so, for how long?
What are the specific risks given where my collection is?
Will I need antibiotics or further treatment after drainage?
How will you confirm the collection has settled, and could it come back?
Who do I contact if the drain blocks or falls out, or I feel unwell?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the radiologist who carries out my procedure, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this procedure not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Is this an operation?

No. It is minimally invasive — a thin tube is placed through a small skin puncture under scan guidance and local anaesthetic, rather than through a surgical cut, so there is no surgical scar.

Will draining it cure the problem?

It removes the collection and helps control infection, but it may not treat the underlying cause. You may still need antibiotics or treatment of the problem that led to the collection.

How long does the drain stay in?

It varies — from being removed at the end of the procedure to staying in for several days while the collection empties. The team removes it once the output falls and scans show it has settled.

Will it hurt?

Local anaesthetic numbs the area, and sedation can help you relax. You may feel pressure as the tube goes in, and the site can be sore afterwards.

What are the main risks?

Bleeding, infection spreading into the bloodstream, and rarely injury to a nearby organ. Most people do well, but it is important to watch for signs of worsening infection and to seek help quickly.

Is it done on the NHS?

Yes, it is a routine NHS procedure, often done urgently or as an emergency when someone has an infected collection. Private access is less common because it is frequently part of acute care.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: CIRSE — Drainage (patient information) BSIR/MFT NHS — Percutaneous drainage (patient leaflet) Percutaneous abscess drainage — StatPearls (NCBI) Complications of percutaneous fluid drainage — PMC review SIR quality improvement standards for image-guided percutaneous drainage — PubMed

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.