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Paracentesis. The procedure to remove abnormal collection of fluid from the peritoneal cavity.
INDICATIONS:
- Differential diagnosis of ascites
- Intraabdominal pressure causing respiratory distress
- Differential diagnosis of acute peritonitis
CONTRAINDICATIONS:
- Acute abdomen requiring immediate surgery (absolute contraindication)
- Coagulopathy (relative contraindication)
- Thrombocytopenia (relative contraindication)
- Severe bowel distension (use extra caution or open technique)
- Previous abdominal surgery, especially pelvic surgery
- Pregnancy (necessitates using open technique above umbilicus after first trimester)
- Distended bladder that cannot be emptied with a Foley catheter
- Obvious infection at intended site of insertion (cellulitis or abcess)
COMPLICATIONS:
- Bladder perforation
- Small or large bowel perforation
- Stomach perforation
- Lacerations of major vessels (mesenteric, iliac, aorta)
- Laceration of catheter or guide wire and loss in peritoneal cavity (might require laparotomy to recover catheter)
- Abdominal wall hematomas
- Incisional hernias
- Wound infection
- Wound dehiscence
- Inability to retrieve majority of instilled fluid
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