Paracentesis[edit]

Illustration of a Paracentesis procedure.

Paracentesis is a medical procedure involving the puncture of the abdominal wall to remove ascitic fluid from the peritoneal cavity. This procedure is primarily used for diagnostic purposes to analyze ascitic fluid in patients with conditions such as ascites, primarily due to cirrhosis, heart failure, or malignancies. Paracentesis can also be therapeutic, providing relief from symptoms associated with fluid accumulation.

Indications[edit]

Paracentesis is indicated for:

Diagnosis of the etiology of new-onset ascites
Evaluation of patients with known ascites presenting with fever, abdominal pain, or other signs of spontaneous bacterial peritonitis (SBP)
Relief of discomfort due to significant ascites

Procedure[edit]

The procedure involves:

Pre-procedural assessment including coagulation status
Patient positioning, typically sitting upright
Skin sterilization and local anesthesia at the puncture site
Insertion of a needle or catheter into the peritoneal cavity to withdraw fluid
Fluid is then sent for analysis, which can include cell count, protein levels, and culture

Diagnostic Significance[edit]

Analysis of ascitic fluid can help diagnose:

Spontaneous bacterial peritonitis (SBP)
Tuberculosis
Malignancies
Portal hypertension related to liver disease

Potential Complications[edit]

Though generally safe, paracentesis can occasionally lead to complications such as:

Bleeding, especially in patients with coagulopathy
Infection
Perforation of the bowel
Hypotension due to rapid removal of large volumes of fluid

Post-procedure Care[edit]

Patients typically require monitoring for signs of bleeding or infection post-procedure. In cases of large-volume paracentesis, albumin may be administered to prevent circulatory dysfunction.

External Links[edit]

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Paracentesis