Patient education: Abdominal paracentesis (The Basics)

What is abdominal paracentesis? — Abdominal paracentesis is a procedure to remove fluid from the belly using a needle. The medical term for fluid in the belly is "ascites." It happens when fluid collects in the space between the organs in the belly and the belly wall (figure 1).

Abdominal paracentesis can be done to:

●Learn more about the fluid in your belly

●Relieve symptoms caused by the extra fluid

How do I prepare for abdominal paracentesis? — Most of the time, you do not need to do anything special to prepare for abdominal paracentesis. Ask the doctor or nurse if you have questions or if there is anything you do not understand.

Before your procedure, your doctor will do an exam and ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

What happens during abdominal paracentesis? — When it is time for the procedure:

●The doctor will put a small mark on your skin where they will insert the needle. Most of the time, this is on the lower left side of your belly. Then, they will clean the skin to lower your chance of an infection.

●The doctor will give you local anesthesia, which is medicine to numb a small area. This is to make sure that you do not feel pain during the procedure.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will use a needle to remove fluid from the belly. Sometimes, they will use ultrasound to help guide the needle into the right position. (An ultrasound creates pictures of the inside of the body.) The doctor will drain some fluid by pulling back on the plunger of a syringe. In some cases, they will attach the needle to tubing to allow the fluid to drain into a bottle. The doctor might send some of the fluid to the lab for testing.

●When they have removed enough fluid, the doctor will pull the needle out. They might ask you to cough as they remove the needle. They will hold pressure on the area to stop any bleeding.

●The doctor will cover the area with clean bandages.

What happens after abdominal paracentesis? — After your procedure, the staff will watch you closely for a short time. If you had a lot of fluid removed, the doctor might order special IV fluids to help your blood pressure.

What are the risks of abdominal paracentesis? — Your doctor will talk to you about all of the possible risks and answer your questions. Possible risks include:

●Fluid leaking from the place where the needle went in

●Bleeding

●Injury to other organs in the belly such as the intestines, liver, or spleen

●A drop in blood pressure

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

The doctor might also ask you to:

●Follow a low-salt (or "low-sodium") diet – This can help reduce the amount of fluid in your belly.

●Take a medicine called a "diuretic" – Diuretics make people urinate much more than usual.

●Avoid alcohol.

●Avoid medicines called "NSAIDs" – These can harm the liver. NSAIDs include aspirin, ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve).

●Check your weight every day – This will help your doctor monitor your condition.

What follow-up care do I need? — The doctor will want to see you again after procedure to check on your progress. Go to these appointments.

When should I call the doctor? — Call for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have redness or swelling around the paracentesis area.

●You have very bad belly pain.

●You have trouble breathing.

●You have bleeding or fluid leaking from the area.

More on this topic

Patient education: Fluid in the belly (ascites) (The Basics)
Patient education: Cirrhosis (The Basics)
Patient education: Low-sodium diet (The Basics)
Patient education: Alcohol use — when is drinking a problem? (The Basics)
Patient education: Swelling (The Basics)

Patient education: Cirrhosis (Beyond the Basics)
Patient education: Low-sodium diet (Beyond the Basics)
Patient education: Alcohol use — when is drinking a problem? (Beyond the Basics)
Patient education: Edema (swelling) (Beyond the Basics)