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Paracentesis

A paracentesis is performed on patients with abnormal collections of fluid, termed ascites, in their abdominal (peritoneal) cavity. Fluid may be removed for either diagnostic or therapeutic reasons. A diagnostic paracentesis is performed to elucidate the cause of ascites. Ascites may accumulate because of systemic illness (such as liver, heart, or kidney disease), or local illness (such as abdominal infections or tumors).

The procedure itself is rather simple. The physician selects a site on the surface of the abdomen either by examining the abdomen or using ultrasound guidance. This site is sterilely prepared with an antiseptic and then infiltrated with a topical anesthetic such as lidocaine. Finally, a small catheter is introduced into the space for sampling of the fluid. Fluid is sent to the laboratory for cell count, biochemical analysis, staining, cultures, cytology, and other special studies.

A therapeutic paracentesis is performed in patients with symptoms related to a large amount of ascites. Symptoms may include shortness of breath, abdominal discomfort, or loss of appetite. The therapeutic paracentesis is identical to a diagnostic paracentesis except that large volumes (sometimes, many liters) of fluid are removed.

Paracentesis is generally an extremely safe procedure. Rare complications include local bleeding or infection.

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