Paracentesis

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What is it and why do I need it?

Paracentesis is a procedure that removes fluid (ascites) from the abdominal cavity. Excess fluid accumulates in the abdomen most often because of cirrhosis, but also occasionally due to heart failure, kidney failure, or certain cancers.

Paracentesis is performed to help determine why fluid is being retained in the abdomen or to rule out an infection in the fluid by obtaining a sample and analyzing it in the laboratory. It is also used to remove large quantities of fluid to relieve abdominal swelling.

The risks

The risks of paracentesis are usually low (under 1%), but do include bleeding, infection and perforation of the bowel of other organs. There is also a small risk of kidney injury or a fluid leak from the site where the needle was inserted. If leaking occurs, it usually resolves in a few days. If you have concerns about these risks, please contact your physician before your procedure. You will also be able to discuss this with your physician at the time of the exam.

The preparation

No specific preparation is required unless your physician provides specific instructions. In some cases, your physician may order an ultrasound test prior to the procedure to mark where the fluid removal site will be.

The procedure

While lying slightly upright in bed, your physician will clean an area on the lower abdomen. A numbing medication will be injected into the skin and then a needle catheter will be advanced into your abdominal cavity. Fluid is then removed and drained which may take ½-2 hours depending on the volume.  Depending on the volume of fluid removed, an IV infusion of albumin protein may be given to reduce the risk of kidney injury. After the fluid has drained, the catheter will be removed and a bandage applied. 

After the procedure

You will be informed if there is any sign of an infection based on a sample of fluid sent to the lab for analysis. You may return to your normal diet and activities when you return home. The bandage can usually be removed in 24-48 hours, although if there is fluid leakage from the site, the bandage may need to be changed and left on longer.