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Paracentesis

Paracentesis is a procedure to take out fluid that has collected in the belly (peritoneal fluid). This fluid buildup is called ascites. Ascites may be caused by infection, inflammation, an injury, or other conditions, such as cirrhosis or cancer. The fluid is taken out using a long, thin needle put through the belly. The fluid is sent to a lab and studied to find the cause of the fluid buildup. Paracentesis also may be done to take the fluid out to relieve belly pressure or pain in people with cancer or cirrhosis.

Your doctor may recommend a Paracentesis to:

  • Find the cause of fluid buildup in the belly
  • 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
  • Check for damage after a belly injury

Before you have paracentesis done, tell your doctor if you are taking any medicine, are allergic to any medicines, including numbing medicines, and have had bleeding problems or are taking blood thinners such as aspirin. Other blood tests may be done before a paracentesis to make sure that you do not have any bleeding or clotting problems. You will empty your bladder before the procedure. You may be asked to sign a consent form. Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean.

This procedure may be done in your doctor's office, an emergency room, the X-ray department of a hospital, or at your bedside in the hospital. If a large amount of fluid is going to be taken out during the procedure, you may lie on your back with your head raised. People who have less fluid taken out may sit up. The site where your doctor will put the needle is cleaned with a special soap and draped with sterile towels. Your doctor puts a numbing medicine into your belly. Once the area is numb, your doctor will gently and slowly put the paracentesis needle in where the extra fluid is likely to be. Your doctor will be careful to not poke any blood vessels or the intestines. If your test is done in the X-ray department, an ultrasound may be used to show where the fluid is in your belly. If a large amount of fluid is present, the paracentesis needle may be hooked by a small tube to a vacuum bottle for the fluid to drain into it. Generally, up to 4ml of fluid is taken out. If your doctor needs to remove a larger amount of fluid, you may be given fluids through an intravenous line (IV) in a vein in your arm. This fluid is needed to prevent low blood pressure or shock.

It is important that you lie completely still during the procedure, unless you are asked to change positions to help drain the fluid. When the fluid has drained, the needle is taken out and a bandage is placed over the site. After the test, your pulse, blood pressure, and temperature are watched for about an hour. You may be weighed and the distance around your belly may be measured before and after the test. Paracentesis takes about 20 to 30 minutes. It will take longer if a large amount of fluid is taken out. You resume your normal activities after the test unless your doctor tells you differently.

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