Paracentesis is a medical procedure that consists of draining fluid from a body cavity. It is usually performed when there is ascites, which is the accumulation of fluid in the abdomen, caused by diseases such as cirrhosis of the liver, cancer or abdominal infections, for example. Understand what ascites is and the diseases it causes.
It is done with the following objectives:
- Diagnostic paracentesis: made to collect a small amount of liquid that will be analyzed in the laboratory to identify the cause of ascites or to look for changes such as infections or cancer cells, for example; Therapeutic paracentesis: it is also called relief paracentesis, as it removes a large amount of fluid. It is usually indicated when the treatment for ascites is not effective, causing an accumulation of bulky fluid that causes discomfort and, in some cases, may hinder breathing.
Paracentesis is usually performed in a hospital or outpatient setting, by a cynical doctor or gastroenterologist, and for the procedure it is necessary that the patient is lying on a stretcher, where cleaning and anesthesia are performed at the puncture site, then A special needle must be inserted to allow the liquid to escape.
What is it for
Paracentesis is usually indicated for the removal of fluid from the abdominal cavity. Normally, the abdomen contains only a small amount of free liquid, however, some situations can cause an abnormal increase in this amount, a situation called ascites or, popularly, water belly.
The main cause of ascites is cirrhosis of the liver, caused by several situations, such as chronic viral hepatitis, alcoholism, autoimmune or genetic diseases, for example. Check out what are the main causes of cirrhosis.
Other conditions that can also cause ascites are tumors or abdominal metastases, congestive heart failure, changes in the kidneys, or even abdominal infections, caused by tuberculosis, schistosomiasis, fungi and bacteria.
How it is done
Paracentesis is performed by the doctor, and the procedure involves the following steps:
- The patient should be lying comfortably on a stretcher; Asepsis and antisepsis is performed on the region that will be punctured, and the doctor must be dressed with materials to avoid contamination such as gloves, apron, cap and mask; Performing local anesthesia where it will be inserted the needle, usually in the lower left region, between the navel area and the iliac crest, or as guided by the ultrasound examination; the puncture was made perpendicular to the skin, with a thick gauge needle, specific for the procedure; collected liquid for the syringe, which can be analyzed in the laboratory; if it is necessary to remove a greater amount of ascitic liquid, the doctor may attach the needle in a serum set connected to a vial that is located at a lower level than the patient's, for that the liquid can be drained, flowing naturally.
In addition, when the amount of liquid drained is greater than 4 liters, it is recommended to use human albumin in the vein, during or shortly after the procedure, in the dose of 6 to 10 grams of albumin per liter removed. This medication is important so that the excess fluid removed does not cause an imbalance between the abdominal fluid and the fluid in the bloodstream.
Possible complications
Although paracentesis is generally a safe procedure, some complications may arise, such as the perforation of some organ of the digestive tract, hemorrhage or infections of the ascitic fluid or abdominal wall.
