What is Paracentesis?

Paracentesis is a procedure that removes extra fluid from the abdomen. That fluid buildup is called ascites. A thin needle and a small flexible catheter are placed through the skin into the fluid space, usually with ultrasound guidance. Fluid then drains out through the catheter.

A small sample may be taken for testing. This is a diagnostic paracentesis. A larger amount may be drained to relieve pressure. This is a therapeutic, or large-volume, paracentesis. The catheter is removed when enough fluid has been drained. It is not a permanent tube.

Why Do I Need It?

Ascites can come from liver scarring (cirrhosis), cancer, infection, inflammation, heart failure, or other causes. Extra fluid can cause:

• Abdominal swelling, tightness, or pain
• Shortness of breath, especially when lying down
• Poor appetite, early fullness, or trouble moving
• The need to test the fluid for infection, cancer cells, or the cause of the buildup

How Do I Prepare?

• Medicines: Tell the team about blood thinners, diabetes medicine, and all other medicines. Some blood thinners may be held.
• Allergies: Report allergies to local anesthetic, latex, iodine, or adhesives.
• Bladder: Empty your bladder just before the procedure so it is less likely to be in the path of the needle.
• Eating: You can often eat and drink normally unless you are told otherwise. Follow the instructions for your appointment.
• Labs and support: They may check blood counts and clotting studies. Arrange a ride if sedation is planned. Most paracentesis procedures use only local anesthetic.

How is it Performed?

• You usually lie on your back with the head of the bed raised. Ultrasound finds a pocket of fluid away from bowel and blood vessels.
• The skin is cleaned. Local anesthetic numbs the site. You may feel a brief sting.
• A needle is placed into the fluid, then a thin catheter is advanced. Fluid drains into a bag or bottle.
• We may send a sample to the lab. Large-volume drainage can take 30 to 90 minutes. Stay still while the catheter is in place.
• The catheter is removed, pressure is held, and a bandage is placed. Albumin may be given by vein if a large amount of fluid is removed.

Care Instructions

• Keep the bandage on for about 24 hours. You may usually shower after that and pat the site dry.
• A small amount of fluid leakage or a wet dressing for a day or two can be normal. Place a clean bandage if it leaks.
• Rest the day of the procedure. Avoid heavy lifting and strenuous activity for 24 to 48 hours.
• You may feel lighter and breathe more easily. Some belly soreness is common.
• Ascites can return. Follow the plan for salt restriction, diuretics, or repeat drainage given by your team.

What to Watch Out For

Contact your care team promptly if you notice:

• Leakage that continues beyond 48 to 72 hours or soaks through several dressings
• Increasing redness, swelling, warmth, or drainage of pus at the site
• Fever, chills, or increasing belly pain
• Dizziness, fainting, or a racing heartbeat
• Blood soaking the bandage or black or bloody stools
• Severe belly pain, trouble breathing, chest pain, or fainting — seek emergency care