ABDOMINAL PARACENTESIS

What is Abdominal Paracentesis?

It is also called ascitic tap. It is a procedure where a small needle is inserted through the abdominal wall to remove fluid from within the abdomen. Collection or accumulation of fluid in the spaces between the organs in the cavity of the abdomen is called ascites.

Why do I need it?

This can be needed in 2 situations:
  • Diagnostic tap: Where a small amount of fluid is removed and sent to the laboratory for analysis to evaluate the cause of ascites
  • Therapeutic: To relieve the pressure from within your abdomen due to excess built of fluid resulting in tense ascites.

What causes the fluid to accumulate in the abdominal cavity?

There are many causes for ascites. Commonest cause is due to underlying liver disease. Other causes:
  • Cancer: cancer cells can spread to the lining of abdominal cavity and cause irritation resulting in build up of fluid
  • Infection: Tuberculosis
  • Heart failure
  • Kidney problems: eg nephrotic syndrome

What are the symptoms?

  • Swelling of the abdomen, with associated pain or discomfort.
  • Discomfort during sitting or moving
  • Breathlessness in case of tense ascites
  • Tiredness.

How is the procedure done?

  • Your abdomen will be examined to determine the site for the paracentesis needle to be inserted. You may need an ultrasound scan to locate the area where the fluid has collected and this site is marked.
  • A blood test may be taken to check that your blood clots normally before the procedure is performed.
  • This procedure can be done as a day case requiring you to stay in hospital for 6 hrs. However you may need to be admitted for overnight monitoring depending on your condition
  • Before the procedure begins you will be asked to empty your bladder. You will need to lie on your back. During the procedure, a needle will be inserted into your abdomen. The fluid (ascites) will drain through this needle into a drainage bag . The tube is usually removed once most of the fluid has been drained and a dressing is  applied over the drainage site.

What are the risks associated with paracentesis?

  • If a large quantity of fluid is removed, there is a slight risk of lowered blood pressure. Your blood pressure, pulse and temperature will be monitored regularly during your stay in hospital.
  • The draining fluid can become blocked. If this happens you may be asked to move around, as this can sometimes clear the blockage. If this does not work then the needle might have to be removed and another one put in.
  • There is a very small risk that your bowel might be punctured during the procedure. This is unlikely but may cause bleeding or infection and could require an operation.

Are there any alternatives to paracentesis?

Some patients may benefit from a medication known as a diuretic, which will make you urinate more frequently than normal. This treatment is only suitable for certain patients and in these circumstances it may slow the build up of fluid in the abdomen.