Safety and efficacy of sonographically guided evacuation of intramuscular, bursal and subcutaneous hematomas

• Published in: Ultraschall in der Medizin - European Journal of Ultrasound
• Main Authors: Szopinski, K, Smigielski, R
• Format: Conference Proceeding
• Language: English; German
• Published: 15.05.2008
• ISSN: 0172-4614; 1438-8782
• DOI: 10.1055/s-2008-1079909

Purpose: The usefulness of evacuating hematomas is debated, some clinicians believe that aspiration leads to an increased risk of secondary infections. The purpose of this study is to evaluate the safety of sonographically guided intramuscular, bursal and subcutaneous hematoma evacuation. Methods and materials: Records of sonographic examinations performed from January 2005 through December 2007at a single institution were reviewed. During this period of time 116 sonographically guided evacuations of intramuscular (n=66), bursal (n=16), subcutaneous (n=9) and postoperative (n=14) hematomas were performed in 85 patients (62 male, 23 female, mean age 40.4, age range 13–80). Clinical records of the patients, which underwent these procedures were reviewed. Results: One hundred (86.2%) hematoma evacuations were successful, 16 (13.8%) were not successful due to excessive density and/or viscosity of the content. The volume of evacuated fluid ranged from 0.5 to 450ml. In 21 (24.7%) patients hematomas recurred and repeat evacuations were necessary. Clinical follow-up records were available for 87 (75%) procedures in 56 (66%) patients, 29 patients did not return for follow-up after hematoma evacuation. No septic or hemorrhagic complications were recorded. Conclusion: Sonographically guided hematoma evacuation is a safe procedure. However, the proportion of unsuccessful evacuations and hematoma recurrence is substantial.