What is a Paracentesis?
A paracentesis is a minimally invasive procedure used to drain fluid from the belly. This fluid is called ascites. This can be done to check if the fluid is infected. It can also be done to relieve discomfort.
How is a Paracentesis done?
The clinician may use ultrasound to find the fluid. The clinician numbs the skin then places a tiny tube into the belly to drain the fluid. Afterwards, the tube is removed and a bandage applied.
Paracentesis Procedure
1. The clinician may use ultrasound to find the fluid in the belly.
2. The clinician numbs the skin. They slide a tiny tube into the belly. The fluid drains out.
3. After, they remove the tube and put a bandage over the pinhole in the skin.
What are the risks?
Paracentesis is generally a safe procedure when performed by a specialist.
The most common complication is leakage of the fluid after the tube is removed. This occurs in 5 in 100 people. Other risks include bleeding (3 in 100 people), infection (less than 1 in 100 people), and injury to the bowel (very, very rare).
What are the alternatives?
Alternative 1 Not doing the paracentesis. This can be an option if there is no concern that the fluid is infected. The fluid could come back. If it is infected, there could be a delay in starting the right treatment.
The next 3 alternatives are for people whose fluid keeps coming back:
Alternative 2 Tunneled drainage catheter. This longer-term tube is placed in your belly to allow you to drain the fluid into special containers at home.
Alternative 3 Denver shunt. This longer-term tube has a small pump beneath the skin to draw the fluid from the belly and return it to the blood through a vein in the neck.
Alternative 4 TIPS. This is a treatment for high blood pressure in the liver. A little tube allows some of the blood to bypass the liver. This can reduce the build-up of fluid in the belly. The risks with TIPS are higher than the other options.
Frequently asked questions
What is a paracentesis?
A paracentesis is a small procedure to remove excess fluid from the abdomen.
Why do I need a paracentesis?
Certain medical conditions can cause excess fluid to build up in the abdomen, including:
Liver disease
Cancer
Heart failure
Kidney disease
When too much fluid builds up in the abdomen, it can become uncomfortable. A paracentesis can be done to relieve symptoms from the excess fluid. Sometimes your doctor may need to remove fluid to test it for infection or signs of other disease.
What happens during a paracentesis?
Your doctor may use an ultrasound to look for a safe pocket of fluid to drain. After cleaning and numbing the skin, your doctor will then place a skinny tube into the fluid in your abdomen through a pinhole. The fluid will drain out into a jar or a bag using mild suction. The procedure usually only takes a few minutes.
Will it hurt?
After the mild sensation of the numbing medicine, the paracentesis will not hurt.
Will I need a second paracentesis?
It is common for fluid to come back days or weeks after a paracentesis. If this happens, you may need to repeat the procedure. Sometimes people need a paracentesis monthly or even weekly.
What are the risks and side effects of a paracentesis?
Paracentesis is usually a safe procedure. Rare, potential complications include:
Bleeding
Infection
Damage to the intestines or other abdominal organs
Your doctor will discuss all of the risks and benefits of the procedure with you before your paracentesis.
Where can I get more information on paracenteses?