Ultrasound-Guided Pigtail Catheter Drainage of Pleural Effusion in the Emergency Department: Effectiveness, Safety, and Clinical Implications

Abstract

Background: Pleural effusion is a common clinical condition encountered in emergency departments and often requires timely therapeutic intervention. This study aimed to assess the effectiveness and safety of ultrasound-guided pigtail catheter drainage in patients presenting with symptomatic pleural effusion. Methods: We conducted a retrospective analysis of 134 drainage procedures performed in a tertiary hospital emergency department in 2024. Adult patients who underwent ultrasound-guided drainage were included regardless of primary diagnosis. Results: Clinical improvement was observed in 86.6% of patients, while radiological improvement—assessed only in cases with complete follow-up imaging—was seen in 56.0%. Procedure-related complications were rare (3.7%), and 50% of patients were discharged directly from the emergency department, highlighting the feasibility of ambulatory management. Nearly half of the patients had underlying malignancy and were receiving palliative care. Conclusions: While indwelling pleural catheters (IPCs) are typically used in long-term outpatient settings, our study focused on temporary pigtail catheter drainage performed in-hospital as a symptom-relieving intervention. The findings align with previous studies supporting the safety and effectiveness of small-bore catheter use in this context. Ultrasound-guided pigtail drainage represents a low-risk, patient-centered approach that can reduce the burden on inpatient services and enhance quality of care for individuals with advanced disease. This method may be considered a first-line option in selected patients presenting with large or symptomatic pleural effusions in acute care settings