Paracentesis - Revision history

Ostermayer: Prepared the page for translation

2026-01-04T23:51:38Z

Prepared the page for translation

← Older revision		Revision as of 23:51, 4 January 2026
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			<languages/>
			<translate>

	==Indications==		==Indications==

	[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]		[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]
	[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]		[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]
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	[[File:Gray399.png\|thumb\|Diagram of sheath of Rectus above the arcuate line.]]		[[File:Gray399.png\|thumb\|Diagram of sheath of Rectus above the arcuate line.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]
	*Rule-out [[SBP]]		*Rule-out [[Special:MyLanguage/SBP\|SBP]]
	*Ascites analysis		*Ascites analysis
	*Clinical deterioration in a patient with ascites (e.g. fever, abdominal pain or tenderness, encephalopathy, acidosis, deterioration in renal function, peripheral leukocytosis)<ref>Runyon B. Diagnostic and therapeutic abdominal paracentesis. UpToDate. "Diagnostic and therapeutic abdominal paracentesis?" Published February 18, 2014. Accessed September 8, 2015.</ref>		*Clinical deterioration in a patient with ascites (e.g. fever, abdominal pain or tenderness, encephalopathy, acidosis, deterioration in renal function, peripheral leukocytosis)<ref>Runyon B. Diagnostic and therapeutic abdominal paracentesis. UpToDate. "Diagnostic and therapeutic abdominal paracentesis?" Published February 18, 2014. Accessed September 8, 2015.</ref>
	*Therapeutic in patient with discomfort from tense ascites		*Therapeutic in patient with discomfort from tense ascites


	==Contraindications==		==Contraindications==

			</translate>
	{{Paracentesis if coagulopathic}}		{{Paracentesis if coagulopathic}}
			<translate>


	==Equipment Needed==		==Equipment Needed==
	*[[Lidocaine]] with epi
	*[[Chlorhexidine]]		*[[Special:MyLanguage/Lidocaine\|Lidocaine]] with epi
			*[[Special:MyLanguage/Chlorhexidine\|Chlorhexidine]]
	*Paracentesis kit (catheter, 11 blade, syringes, bandage)		*Paracentesis kit (catheter, 11 blade, syringes, bandage)
	*[[FAST exam\|Abdominal bedside ultrasound]]		*[[Special:MyLanguage/FAST exam\|Abdominal bedside ultrasound]]
	*Vacuumed bottles		*Vacuumed bottles


	==Procedure==		==Procedure==

	#Use ultrasound to identify safe ascites pocket to drain and mark the area of entry if possible		#Use ultrasound to identify safe ascites pocket to drain and mark the area of entry if possible
	#*if no ultrasound available, can percuss to identify pocket		#*if no ultrasound available, can percuss to identify pocket
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	#Use needle to enter peritoneum, advance catheter upon withdrawing ascitic fluid		#Use needle to enter peritoneum, advance catheter upon withdrawing ascitic fluid
	#Attach cathether to vacuum bottles for therapeutic tap, Withdrawal with syringe for diagnostic tap		#Attach cathether to vacuum bottles for therapeutic tap, Withdrawal with syringe for diagnostic tap


	===Albumin===		===Albumin===
	*Consider [[albumin]] infusion of 1.5gm/kg in cirrhotics with [[SBP]] or with renal insufficiency to reduces the risk of circulatory dysfunction and [[hepatorenal syndrome]]<ref>Kwok CS, Krupa L, Mahtani A, et al. Albumin Reduces Paracentesis-Induced Circulatory Dysfunction and Reduces Death and Renal Impairment among Patients with Cirrhosis and Infection: A Systematic Review and Meta-Analysis. Biomed Res Int. 2013; 2013: 295153.</ref>
			*Consider [[Special:MyLanguage/albumin\|albumin]] infusion of 1.5gm/kg in cirrhotics with [[Special:MyLanguage/SBP\|SBP]] or with renal insufficiency to reduces the risk of circulatory dysfunction and [[Special:MyLanguage/hepatorenal syndrome\|hepatorenal syndrome]]<ref>Kwok CS, Krupa L, Mahtani A, et al. Albumin Reduces Paracentesis-Induced Circulatory Dysfunction and Reduces Death and Renal Impairment among Patients with Cirrhosis and Infection: A Systematic Review and Meta-Analysis. Biomed Res Int. 2013; 2013: 295153.</ref>


	===Pearls===		===Pearls===

	*Placing culture in blood culture tube increases yield		*Placing culture in blood culture tube increases yield
	*Z-track method involves pulling skin downwards with one hand while inserting needle to create nonlinear track		*Z-track method involves pulling skin downwards with one hand while inserting needle to create nonlinear track
	**Theoretically reduces risk of ascitic leak		**Theoretically reduces risk of ascitic leak


	==Workup==		==Workup==

			</translate>
	{{SBP workup}}		{{SBP workup}}
			<translate>


	==Evaluation==		==Evaluation==

			</translate>
	{{Diagnosis of SBP}}		{{Diagnosis of SBP}}
			<translate>

			</translate>
	{{Spontaneous versus secondary bacterial peritonitis}}		{{Spontaneous versus secondary bacterial peritonitis}}
			<translate>


	==Complications==		==Complications==

	*Hemorrhage (0 to 0.93%)<ref>Scheer D, Secko M, Mehta N. ACEP Focus On: Ultrasound-Guided Paracentesis. http://www.acep.org/Education/Continuing-Medical-Education-(CME)/Focus-On/Focus-On--Ultrasound-Guided-Paracentesis. Published on November 1, 2012. Accessed on September 8, 2015.</ref>		*Hemorrhage (0 to 0.93%)<ref>Scheer D, Secko M, Mehta N. ACEP Focus On: Ultrasound-Guided Paracentesis. http://www.acep.org/Education/Continuing-Medical-Education-(CME)/Focus-On/Focus-On--Ultrasound-Guided-Paracentesis. Published on November 1, 2012. Accessed on September 8, 2015.</ref>
	*Abdominal wall hematoma		*Abdominal wall hematoma
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	*Persistent ascitic fluid leak (5%)		*Persistent ascitic fluid leak (5%)
	**May be minimized with Z-track method		**May be minimized with Z-track method


	==See Also==		==See Also==
	*[[Ascites]]
	*[[Spontaneous bacterial peritonitis]] (SBP)		*[[Special:MyLanguage/Ascites\|Ascites]]
			*[[Special:MyLanguage/Spontaneous bacterial peritonitis\|Spontaneous bacterial peritonitis]] (SBP)


	==External Links==		==External Links==

	*[http://www.acep.org/Education/Continuing-Medical-Education-(CME)/Focus-On/Focus-On--Ultrasound-Guided-Paracentesis/ Focus On: Ultrasound-Guided Paracentesis]		*[http://www.acep.org/Education/Continuing-Medical-Education-(CME)/Focus-On/Focus-On--Ultrasound-Guided-Paracentesis/ Focus On: Ultrasound-Guided Paracentesis]
	*[https://www.merckmanuals.com/professional/gastrointestinal-disorders/how-to-do-gastrointestinal-procedures/how-to-do-paracentesis?query=paracentesis\| Merk Manual: How to do Paracentesis]		*[https://www.merckmanuals.com/professional/gastrointestinal-disorders/how-to-do-gastrointestinal-procedures/how-to-do-paracentesis?query=paracentesis\| Merk Manual: How to do Paracentesis]


	===Videos===		===Videos===

	*NEJM (9:50) https://www.nejm.org/doi/full/10.1056/NEJMvcm062234		*NEJM (9:50) https://www.nejm.org/doi/full/10.1056/NEJMvcm062234


	==References==		==References==

	<references/>		<references/>

	[[Category:Procedures]]		[[Category:Procedures]]
	[[Category:GI]]		[[Category:GI]]
			</translate>

Rossdonaldson1: /* Indications */

2025-03-05T17:35:51Z

Indications

← Older revision		Revision as of 17:35, 5 March 2025
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	[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]		[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]
	[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]		[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]
			[[File:Gray399.png\|thumb\|Diagram of sheath of Rectus above the arcuate line.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]
	*Rule-out [[SBP]]		*Rule-out [[SBP]]

Rossdonaldson1: /* Indications */

2025-03-05T17:07:52Z

Indications

← Older revision		Revision as of 17:07, 5 March 2025
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	==Indications==		==Indications==
	[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]		[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]
	[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half~~. Not the inferior epigastric vessels (artery and vein), which should be avoided during paracentesis. The inferior epigastric vein may be abnormally distended with cirrhosis~~.]]		[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]
	[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]		[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]

Rossdonaldson1: /* Indications */

2025-03-05T17:07:42Z

Indications

← Older revision		Revision as of 17:07, 5 March 2025
Line 1:		Line 1:
	==Indications==		==Indications==
	[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]		[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]
	[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]		[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half. Not the inferior epigastric vessels (artery and vein), which should be avoided during paracentesis. The inferior epigastric vein may be abnormally distended with cirrhosis.]]
	[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]		[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]

Rossdonaldson1 at 16:49, 5 March 2025

2025-03-05T16:49:45Z

← Older revision		Revision as of 16:49, 5 March 2025
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	[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]		[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]
	[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]		[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]
	[[File:~~Gray399~~.~~svg~~\|thumb\|~~Diagram~~ of ~~sheath of rectus above~~ the ~~arcuate line~~.]]		[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]
	*Rule-out [[SBP]]		*Rule-out [[SBP]]

Rossdonaldson1: /* Indications */

2025-03-05T16:46:36Z

Indications

← Older revision		Revision as of 16:46, 5 March 2025
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	==Indications==		==Indications==
	[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]		[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]
			[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]
	[[File:Gray399.svg\|thumb\|Diagram of sheath of rectus above the arcuate line.]]		[[File:Gray399.svg\|thumb\|Diagram of sheath of rectus above the arcuate line.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]

Rossdonaldson1: /* Indications */

2025-03-05T16:42:13Z

Indications

← Older revision		Revision as of 16:42, 5 March 2025
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	==Indications==		==Indications==
	[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]		[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]
			[[File:Gray399.svg\|thumb\|Diagram of sheath of rectus above the arcuate line.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]
	*Rule-out [[SBP]]		*Rule-out [[SBP]]

Rossdonaldson1: /* See Also */

2025-03-05T16:37:57Z

Rossdonaldson1: /* Indications */

2025-03-05T16:37:20Z

Indications

← Older revision		Revision as of 16:37, 5 March 2025
Line 1:		Line 1:
	==Indications==		==Indications==
			[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]
			[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]
	*Rule-out [[SBP]]		*Rule-out [[SBP]]
	*Ascites analysis		*Ascites analysis

Rossdonaldson1: /* External Links */

2025-02-26T22:43:49Z

External Links

← Older revision		Revision as of 22:43, 26 February 2025
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	===Videos===		===Videos===
	*NEJM (9:50) https://www.nejm.org/doi/full/10.1056/NEJMvcm062234		*NEJM (9:50) https://www.nejm.org/doi/full/10.1056/NEJMvcm062234

	~~{{#widget:YouTube\|id=9npNQM8ANds}}~~

	==References==		==References==

← Older revision		Revision as of 17:35, 5 March 2025
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	[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]		[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]
	[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]		[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]
			[[File:Gray399.png\|thumb\|Diagram of sheath of Rectus above the arcuate line.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]
	*Rule-out [[SBP]]		*Rule-out [[SBP]]

← Older revision		Revision as of 17:07, 5 March 2025
Line 1:		Line 1:
	==Indications==		==Indications==
	[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]		[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]
	[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half~~. Not the inferior epigastric vessels (artery and vein), which should be avoided during paracentesis. The inferior epigastric vein may be abnormally distended with cirrhosis~~.]]		[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]
	[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]		[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]

← Older revision		Revision as of 17:07, 5 March 2025
Line 1:		Line 1:
	==Indications==		==Indications==
	[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]		[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]
	[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]		[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half. Not the inferior epigastric vessels (artery and vein), which should be avoided during paracentesis. The inferior epigastric vein may be abnormally distended with cirrhosis.]]
	[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]		[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]

← Older revision		Revision as of 16:49, 5 March 2025
Line 2:		Line 2:
	[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]		[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]
	[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]		[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]
	[[File:~~Gray399~~.~~svg~~\|thumb\|~~Diagram~~ of ~~sheath of rectus above~~ the ~~arcuate line~~.]]		[[File:Hesselbach triangle 547.gif\|thumb\|View of Hesselbach's triangle from inside the abdomen showing the right inferior epigastric artery and vein arching superio-medially.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]
	*Rule-out [[SBP]]		*Rule-out [[SBP]]

← Older revision		Revision as of 16:46, 5 March 2025
Line 1:		Line 1:
	==Indications==		==Indications==
	[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]		[[File:Scheme body cavities-en.png\|thumb\|Lateral view showing abdominopelvic cavity.]]
			[[File:Gray1036.png\|thumb\|Posterior view of the anterior abdominal wall in its lower half.]]
	[[File:Gray399.svg\|thumb\|Diagram of sheath of rectus above the arcuate line.]]		[[File:Gray399.svg\|thumb\|Diagram of sheath of rectus above the arcuate line.]]
	[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]		[[File:Auscities.png\|thumb\|Ascites appearance on ultrasound]]

← Older revision		Revision as of 16:37, 5 March 2025
Line 57:		Line 57:

	==See Also==		==See Also==
	*[[Spontaneous ~~Bacterial Peritonitis~~ (SBP)]]		*[[Ascites]]
			*[[Spontaneous bacterial peritonitis]] (SBP)

	==External Links==		==External Links==