What is Paracentesis

Paracentesis is a procedure to remove excess fluid (ascites) from the belly (abdomen). Ascites can result from certain conditions, such as infection, inflammation, abdominal injury, heart failure, chronic scarring of the liver (cirrhosis), or cancer. Ascites is removed using a needle that is inserted through the skin and tissue into the abdomen.

This procedure may be done:

• To determine the cause of the ascites.
• To relieve symptoms that are caused by the ascites, such as pain or shortness of breath.
• To see if there is bleeding after an abdominal injury.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Injury to an abdominal organ, such as the bowel (large intestine), liver, spleen, or bladder.
• Low blood pressure (hypotension).
• Spreading of cancer, if there are cancer cells in the abdominal fluid.
• Mental status changes in people who have liver disease. These changes would be caused by shifts in the balance of fluids and minerals (electrolytes) in the body.

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• A blood sample may be done to determine your blood clotting time.
• You will be asked to urinate.

What happens during the procedure?

• You may be asked to lie on your back with your head raised (elevated).
• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• You will be given a medicine to numb the area (local anesthetic).
• Your abdominal skin will be punctured with a needle or a scalpel.
• A drainage tube will be inserted through the puncture site. Fluid will drain through the tube into a container.
• After enough fluid has been removed, the tube will be removed.
• A sample of the fluid will be sent for examination.
• A bandage (dressing) will be placed over the puncture site.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• It is your responsibility to get your test results. Ask your health care provider or the department performing the test when your results will be ready.

Paracentesis, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After your procedure, it is common to have a small amount of clear fluid coming from the puncture site.

Follow these instructions at home:

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take baths, swim, or use a hot tub until your health care provider approves.
• Follow instructions from your health care provider about:
  • How to take care of your puncture site.
  • When and how you should change your bandage (dressing).
  • When you should remove your dressing.
• Check your puncture area every day signs of infection. Watch for:
  • Redness, swelling, or pain.
  • Fluid, blood, or pus.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have redness, swelling, or pain at your puncture site.
• You start to have more clear fluid coming from your puncture site.
• You have blood or pus coming from your puncture site.
• You have chills.
• You have a fever.

Get help right away if:

• You develop chest pain or shortness of breath.
• You develop increasing pain, discomfort, or swelling in your abdomen.
• You feel dizzy or light-headed or you pass out.