Image-Guided Palliative Care (TH364)

Abstract

•Develop a treatment plan that differentiates between those with a fully expanding lung and those with a fibrinothorax.•Determine different diagnostic tests and maintenance options that would be realistic and effective for that clinical setting.•List the 3 therapeutic options for celiac plexus blocks and their relative effectiveness areas of planning for physical therapy services. Image-guided palliative care is an underused therapy that can provide pain and symptom relief. These treatments can be provided by any physician with access to quality ultrasound, fluoroscopy, and computed tomography (CT) equipment. However, the efficacies and risks of the therapies may be different based on the technique and equipment used for the image-guided treatment and the timing of these treatments. This session will describe commonly encountered palliative problems that can be mitigated with image-guided and percutaneous therapies. A continuance of the 2018 interventional radiology presentation, this discussion will address different topics and will include efficacy, options, and risk data on each of the image-guided treatment options. Celiac plexus neurolysis will be reviewed again this year because of its importance in pain management, but we will concentrate on non-radiology based options (endoscopic ultrasound directed versus percutaneous CT-guided) and optimal timing of these 2 treatment options. The following topics will be discussed: the decision-making process and treatment of recurrent benign and malignant pleural effusions with special emphasis on the diagnosis and treatment of fibrinothorax (trapped lung), celiac plexus neurolysis for upper abdominal cancer pain, treatment options for recurrent cirrhotic and malignant ascites, gastrostomy tube insertion options and risks as well as recognition and treatment of late complications such as skin burns and intussusception, and catheter-based palliation of obstructive jaundice and cholecystitis. Finally, the presenters will review the efficacy and risks of intercostal neurolysis (rib blocks) for chest wall pain as well as how any physician can master this simple technique which can be performed without any image-guidance.