When is paracentesis indicated?

Abdominal paracentesis is a safe and effective diagnostic and therapeutic procedure used in the evaluation of a variety of abdominal problems, including ascites, abdominal injury, acute abdomen, and peritonitis. Ascites may be recognized on physical examination as abdominal distention and the presence of a fluid wave.

What is the purpose of abdominal paracentesis?

An abdominal paracentesis is a procedure done to remove fluid from the abdominal cavity. This may be a sample removal for testing purposes or a treatment for patients who have fluid in the abdomen (ascites).

What conditions require paracentesis?

The most common reasons to perform paracentesis is to: Diagnose an infection. Check for certain types of cancer. Relieve pressure in the abdomen….Risks

• Accidental penetration of the bladder, bowel or a blood vessel.
• Internal bleeding.
• Low blood pressure.
• Decreased kidney function after fluid is removed.

What is ascites an indication of?

Causes of transudative ascites include the following: Hepatic cirrhosis. Alcoholic hepatitis. Heart failure. Fulminant hepatic failure.

When should you not do paracentesis?

An acute abdomen that requires surgery is an absolute contraindication. Severe thrombocytopenia (platelet count < 20 × 103/μL) and coagulopathy (international normalized ratio [INR] >2.0) are relative contraindications. Other relative contraindications include the following: Pregnancy.

What are the side effects of a paracentesis?

Some side effects may include:

• discomfort or pain where the needle or catheter is inserted.
• dizziness or light-headedness, especially if a lot of fluid is removed.
• infection.
• puncture of the bowel, bladder or blood vessels when the needle is put into the cavity.
• low blood pressure or shock.
• kidney failure.

Is abdominal paracentesis painful?

A paracentesis, or an abdominal tap, is a procedure that removes ascites (build-up of fluid) from your abdomen (belly). The fluid buildup can be painful.

What is the best position for a patient with ascites?

Patients with severe ascites can be positioned supine. Patients with mild ascites may need to be positioned in the lateral decubitus position, with the skin entry site near the gurney. Position the patient in bed with the head elevated at 45-60 degrees to allow fluid to accumulate in the lower abdomen.

What are the contraindications for paracentesis?

What are the contraindications for paracentesis?

• Pregnancy.
• Distended urinary bladder.
• Abdominal-wall cellulitis.
• Distended bowel.
• Intra-abdominal adhesions.

How painful is a paracentesis?

An area will be selected for the paracentesis catheter to be placed. You may feel a brief, sharp sting when the numbing medicine is given. When the paracentesis catheter is put into your belly, you may feel a temporary sharp pain or pressure. You may feel dizzy or lightheaded if a large amount of fluid is taken out.

How is paracentesis used to treat abdominal pain?

Therapeutic paracentesis refers to the removal of five liters or more of fluid to reduce intra-abdominal pressure and relieve the associated dyspnea, abdominal pain, and early satiety [ 2 ]. This topic will review the performance of abdominal paracentesis. Ascitic fluid analysis and the differential diagnosis of ascites are discussed elsewhere.

Which is the best indication for paracentesis WikEM?

Indications 1 Rule-out SBP 2 Ascites analysis 3 Clinical deterioration in a patient with ascites (e.g. fever, abdominal pain or tenderness, encephalopathy, acidosis, deterioration in renal function, peripheral leukocytosis) 4 Therapeutic in patient with discomfort from tense ascites

How is paracentesis used to diagnose ascites?

The Use of Paracentesis in the Assessment of the Patient With Ascites. Ann Emerg Med 2009, 54 (3): 465-68. ↑ Runyon BA, Montano AA, Akriviadis EA, et al. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites.

Is it painful to have a paracentesis tap?

A paracentesis, or an abdominal tap, is a procedure that removes ascites (build-up of fluid) from your abdomen (belly). The fluid buildup can be painful.