Your Health - Abdominal Paracentesis

Abdominal Paracentesis

(Ascites Fluid Tap; Abdominal Tap)

Definition

Usually, there is very little fluid in the abdominal cavity. However, there are a number of conditions that can cause fluid to accumulate in the abdomen. This is called ascites. When fluid accumulates, an abdominal paracentesis may be done. With this procedure, a needle is used to remove a sample of fluid or to drain fluid that has accumulated.

Ascites

Reasons for Procedure

This is done to find out why there is fluid build up in the abdomen. Causes may include:

Bleeding
Infection
Diseases of organs such as the liver

This procedure may also be done when fluid in the abdomen:

Makes breathing difficult
Causes pain

Abdominal fluid can recur until the condition causing it has been treated. You may need to have the procedure again.

Possible Complications

Complications are rare but no procedure is completely free of risk. If you are planning to have an abdominal paracentesis, your doctor will review a list of possible complications which may include:

Bleeding
Infection
Accidental piercing of structures in the abdomen

Some factors that may increase the risk of complications include:

Bleeding disorder
Poor Nutrition
Pregnancy
Full Bladder
Infection in the area where the paracentesis instrument will be inserted

Be sure to discuss these risks with your doctor before the procedure.

What to Expect

Prior to Procedure

Your doctor may do some or all of the following:

Physical exam
Blood tests to make sure your blood clots normally
X-ray—a test that uses radiation to take a picture of structures inside the body
CT scan—a type of x-ray that uses a computer to make pictures of structures inside the body
Ultrasound—a test that uses sound waves to examine parts of the body
MRI scan—a test that uses magnetic waves to make pictures of structures inside of the abdomen

If the procedure is scheduled (rather than done in an emergency):

Do not eat or drink for 12 hours before the procedure.
Empty your bladder just before the procedure.

Anesthesia

You will receive local anesthesia. The area will become numb. You will stay awake during the procedure.

Description of the Procedure

This is usually done in the doctor's office. In some cases, your doctor may have you go to the hospital before or after this procedure. If you are already in the hospital for a different reason, this procedure will not extend your stay.

In most cases, you will lie on your back but in some instances you may need to be in a different position. The area where the needle will be inserted is cleaned with a solution and draped with sterile cloths. An injection of a local anesthetic will be given to numb the area. The doctor will carefully insert the needle into the abdomen. The fluid will be removed using a syringe.

The amount of fluid removed depends on your condition. If it is being done to make a diagnosis, the doctor will remove a small amount of fluid. If the procedure is being done to make you feel better, more fluid may be removed.

How Long Will It Take?

About 10-15 minutes (depending on how much fluid needs to be removed)

How Much Will It Hurt?

There will be some stinging or burning while the anesthesia is injected. Once the area is numb, you will not feel pain.

Post-procedure Care

At the Care Center

You will stay in the recovery room for a few hours. Your blood pressure and other vital signs will be monitored. If you have a lot of fluid leakage or are having trouble breathing, you may need to stay in the care center.

At Home

Rest the day after your procedure.
Follow your doctor's instructions.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or fluid from the paracentesis site
Pain that you can't control with the medications you've been given
Cough, shortness of breath, feeling of faint, or chest pain
Swelling of the abdomen

In case of an emergency call 911.

RESOURCES:

American Cancer Society
http://www.cancer.org/docroot/home/index.asp/

Family Doctor.org
http://familydoctor.org/online/famdocen/home.html/

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca/

Health Canada
http://www.hc-sc.gc.ca/index_e.html/

References:

Aslam N, Marino CR. Malignant ascites: new concepts in pathophysiology, diagnosis, and management. Arch Intern Med. 2001;161:2733-2737.

Berkow R, Beers M, Fletcher AJ. The Merck Manual of Diagnosis and Therapy. New York, NY: Pocket Books; 1999.

Braunwald E, Fauci AS, et al. Harrison's Principles of Internal Medicine. 15th ed. New York, NY: McGraw-Hill Professional; 2001.

Covey AM. Management of malignant pleural effusions and ascites. The Journal of Supportive Oncology. 2005;3:169-173.

Smith EM, Jayson GC. The current and future management of malignant ascites. Clin Oncol. 2003;15:59-72.

Townsend C, Beauchamp DR, et al. Sabiston Textbook of Surgery. 16th ed. Philadelphia, PA: WB Saunders; 2001.

Last reviewed September 2009 by Daus Mahnke, MD and Brian P. Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.