 efficacy, feasibility, and safety of perfidious, in each bagged, physical drainage of abdominal fluid collections. I'm Dr. Aishwarya Vidwal, junior resident from Kasturba Medical College, Mangalore. So my aim of the study was to evaluate the efficacy, feasibility, and safety of perfidious catheter drainage of abdominal fluid collections, and to also compare it with the perfidious catheter or with the traditional methods like intermediate, plain needle aspiration, or open surgical drainage wherever possible, to also assess the reasons for failure and computations of this modality. And also to conclude the safest access pathway with a mining imaging modality beside the fluid collections. So we conducted the study in the Department of Legal Diagnosis, KMC hospitals, Atavar, and Ambedkar circles, and the District Mangalore Hospital, Mangalore. We conducted the study over a period of two years, and those patients who were diagnosed to have fluid fluid cavity in abdomen who were referred from clinician were included in the study. The sample size was around 51. So those patients who recovered very well and intermediate needle aspiration were excluded from the study. And we did not conduct the study or we did not do the procedure, and patients would severely derange the decoagulation profile. And also in those patients whom our safest possible access pathway was not determined. So initially we went about with pre-presidential preparation, written informed consent, and coagulation profile. The patient was placed in a convenient, suitable position. And under local anesthesia, a needle aspiration was performed as an initial step until no further fluid was aspirated. If the patient recovered, if there was complete collapse of cavity, on even unrepeated imaging that was done on day three or 72 hours, those patients were not included in the study. But however, if needle aspiration followed by catheter insertion was done in the same sitting, or it was done after a natural gap of three days, it was considered in the study. We did use the direct puncture technique to introduce the catheter into the collection. And after the range of catheter, the cavity was completely aspirated, repeat imaging on day three was done for the complications and recovery well-assisted based on the clinical command recovery, surgical drainage was assisted if it was needed or not. So these are the parts of the catheterization. You can see the needle protection sheet function needle. This is the connector. This is the catheter and the outer sheet. So initial imaging was done before the procedure. Then the direct puncture needle technique is used and the catheter's puncture needle is withdrawn while the catheter is pushed forward. And then you can see this needle was used aspirated just to initiate the free fluid drainage. And then it was connected to your back via connector. Then post-topical catheterization imaging was obtained to check if the catheter was in place and then secured, the catheter was secured. Then this is the collection of drainage back and then the samples were forwarded to laboratory for diagnostic evaluation. And at this time of discharge, we divided the patients into three groups, group A which included both the modalities in the same setting and group B after an interval gap and group C who needed open surgical drainage. So this was a performer we used on our study and suitable imaging modality or the catheter was completely operated dependent based on the location, size and the characteristics of the fluid collection if it was a separated, ecogenic or dense collection whether they're breeze or not. Then outcome of imaging was, outcome on imaging was defined as the basis of success and failure. Like success was defined if there was a complete collapse of the cavity or if the volume of the fluid collection was reduced by 70% or more, we determine it, we define it as adequate drainage. Otherwise we call it failure. If there was re-accumulation results called as failure. This is a few of the cases which we included in our study. This is the first case for three-year-old child who was diagnosed with retroperitonal rabdomyoma. He had a large pelvic mass which encased bilateral rotors causing gross hydroelectric nephrosis. So we did percutimus subcutitonephrostomy in this case and the patient had a satisfactory of failure to tell his system. And as there was another patient with severe abdominal pain and fever since 15 days, he also had a picture of amylase and lipase which was raised. So on imaging we had, it was formed to be having a pancreatitis and he also had a, which had a peri-pancreatic and perisplimic pseudosist. So this was again, it covered the on-pill catheterization. So negative, it was malignancy however, but it was infected collection. Then other case, percuticratitis pancreatitis, which is a large collection which is almost going down to a left iliac fossa. We put in the catheter there, but then later there is somehow dislodged. So we had to replace the catheter while we replaced the catheter. Initially we used 8.5 French, then we upsized it to 10 French, then it was better positioned and it was very well-dreamed. So this is another experimental lab study which we did in the status patient where it was a case of emphysemitis necropysin pancreatitis dispensing multiple airlock hues and was a large collection as well. So we put in two catheters by our peritoneal one and the other one was retroperitoneal approach. So we irrigated the NS in the normal saline in one of the catheters and we used to use other catheter to drain the collection. That way all the large airlock hues and the depdies which was sedimented all of them cleared out very well. So the patient did not go for surgery rather recovered very well just by picot catheterization. So this is another case with Crohn's abscess which needed immediate intervention. So however they went about doing the section master muscle in this case which was but however deferred for a longer time because patient was not so stable in the beginning but picot catheterization definitely helped the patient. Recover from the abscess. So on the case where ripple surgery was done pancreatic odiotic plenium was done where you can see the post-op collection was there which was again very well drained on picot catheterization. So these are the results of my study with sex distribution age and the capillary size in mostly your size was 12 French for it by 10 and 8.5. Mostly puerin flow which was seen and then serocyanin was hemorrhage and various. So complications we classified as major and minor. Most of the patients had pain at the site of catheter insertion which is classified as a pain or minor and followed by new complications in few of them. And some of them also had perinephric hematomas and pre-satron hematomas on one of the patient had blockage or dislargement of catheter. Then this is the career success and failure for definitions of groups, both the groups. However, there was no significant difference in the both the categorized group distribution. So we concluded that there's no much of a difference in both the groups in the same setting between insert catheter or the daily after period of three days because but however, we now study, we had few limitations. We couldn't compare, have a direct comparison between the open surgical drainage in all the cases but wherever possible we did compare and mostly we could not also have a separate tool or the analysis of different sizes of catheter to be used in the same patient. So we conclude that however, the two groups were not showing much difference. So how only our intermediate radial aspiration as an initial step would help in easy and free drainage of the fluid. Guiding, it also helps in guiding the access pipeline of the catheter placement and collection of the uncontaminated samples for laboratory evaluation. Accesses need immediate intervention. So we did, we have, we did in our study, we did the catheterization and the needle aspiration in the same setting and a few of the complications were reported but however, the very minor and very low rate. So we conclude that percutimus catheter drainage was very effective in training various types of fluid collection, most commonly purulent and serious. So the time saved during this procedure and under the guidance of imaging modality to make this procedure very preferred treatment modality. And intermediate needle aspiration when done as a first step and if it's helpful in delaying the percutimus catheter drainage then it is very much needed. Thank you.