Paracentesis | Vascular

What is a Paracentesis?

Paracentesis is a procedure to remove excess fluid (ascites) from the abdomen, specifically within the peritoneal cavity that encases the intestines and other abdominal organs.

Why do I need this procedure?

You developed fluid in your abdomen (ascites). This can cause you to have distention of your abdomen, abdominal pain, constipation, and sometimes difficulty breathing, especially when you walk or do any sort of activity. The fluid in the abdomen can also make it hard to eat normally.

There are many reasons why this fluid has accumulated and sometimes we don’t know – in which case we will send the fluid for various tests. Ascites can result from certain conditions, such as infection, inflammation, abdominal injury, heart failure, chronic scarring of the liver (cirrhosis), or cancer. We may need to draw some blood at the same time to compare test results between the blood and fluid.

How the procedure is done:

You will be asked to lie on an exam table with your head slightly elevated.
A limited ultrasound will be performed on your abdomen to assess for ascites.
Once an adequate area where fluid is seen, the site will be cleansed and sterilized.
A medication to numb the area (local anesthetic) will then be administered to the procedure site.
A small needle with a catheter on it will then puncture through the skin and abdominal wall into the peritoneal space where the ascites is.
The needle will then be removed and a small drainage catheter will remain in place and attached to a vacuum sealed bottle where fluid will be drawn into.
After enough fluid has been removed, the tube will be removed.
A small amount of sterile skin glue will be applied over the puncture site.
The fluid may be sent for testing.

What are the risks?

Using ultrasound guidance during paracentesis helps keep the risks low. As with any procedure, there is a small risk of bleeding at the puncture site and a very small risk of infection. Specially for paracentesis, we visualize the anatomy inside the abdomen with the ultrasound and find a space in peritoneal fluid. Of course there is always risk or injury to an adjacent structure, but being able to visualize during the entire procedure keeps this risk very low.

General Instructions:

Activity and Diet

You may resume your regular activities (including driving) unless you have been restricted for another reason.
You can continue your normal activity.
You may shower the same day as the procedure.
You can resume your normal diet.

Pain Management

You may use an ice pack on the procedure site and/or over the counter medication such as acetaminophen (Tylenol) or ibuprofen (Advil /Motrin) for minor discomfort unless you are restricted from taking these medications.
If you feel that Tylenol or Advil are not enough for pain control, please contact the Vascular and Interventional Radiology Clinic at 650-404-8445.

What should I watch for?

You may be sore after the procedure, but this should not get worse and should subside within a day or two. However, these are the things you should watch for:

Increased abdominal pain or worsened abdominal distention
Leakage of fluid from the site where the paracentesis was performed
New dizziness, especially when you sit or stand up
Fever >101.5F

Who should I call if I have a problem?

You can reach your Interventional radiologist at 650-404-8445 during M-F 8-5 pm or the physician can be reached through the operator after-hours or on weekends by calling 408 739-6000 and asking for the Interventional Radiologist “on call.”

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