Paracentesis

Using ultrasound guidance, the abdomen is scanned to show where the excess fluid buildup is, and then it is drained using sterile technique to prevent infection. The procedure involves inserting a needle into the abdomen to remove peritoneal fluid.

A clinical staff member will bring you into the procedure area. Your doctor will greet you, review the procedure, and answer any questions you may have.

You will be lying down on your back. Ultrasound will be used to scan your abdomen and select an area for the paracentesis catheter to be placed. You may feel a brief, sharp sting when the numbing medicine (such as lidocaine) is given. When the paracentesis catheter is inserted into your belly, you may feel a temporary sharp pain or pressure. The needle will then be used to drain the excess fluid.

You may feel dizzy or lightheaded if a large amount of fluid is taken out. Tell your doctor if you do not feel well during the test. After the procedure, you may have some clear fluid draining from the puncture site, especially if a large amount of fluid was taken out. The drainage will get less in 1 to 2 days. A small gauze pad and bandage may be needed.

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. You might like to keep a list of questions or—as you’re doing now—educate yourself about the procedure.

Another important part of your preparation will be guided by your doctor:

• Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), or blood thinners (such as Coumadin, Warfarin, Plavix, Fragmin) for a time before the procedure.

Some of your preparation will need to be timed to the procedure:

• • Take your medications as instructed.
  • When you arrive, make sure the clinical staff member and radiologist know about any allergies you may have, especially allergies to local anesthetics (such as lidocaine). If there’s any chance you might be pregnant, tell your radiologist.

• Wear comfortable, loose-fitting clothes.
• Wear comfortable shoes.
• Avoid bringing jewelry or valuables.

The benefits of Paracentesis could be:

• Find the cause of fluid buildup.
• Diagnose an infection in the peritoneal fluid.
• Check for certain types of cancer, such as liver cancer.
• Remove a large amount of fluid that is causing pain or difficulty breathing, or that is affecting how the kidneys or the intestines (bowel) are working.

Risks you should be aware of include:

• There is a very small chance that the paracentesis needle may poke the bladder, bowel, or a blood vessel in the belly. There is also a small chance of infection at the puncture site.
• You may experience a drop in blood pressure if a large amount of fluid is removed.

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.