What is a paracentesis?

A paracentesis is a procedure to remove excess fluid from your abdomen (belly). If this fluid builds up in the abdomen, the condition is called ascites. A catheter (a long, thin, hollow plastic tube) is inserted through the skin and into the abdomen to obtain the excess fluid. A small sample may be taken and tested for problems. If the fluid buildup is causing discomfort or pain, all of the fluid may be drained. To do this, a tube is attached to the catheter and the fluid is drained into a container that sits outside of the body.

Preparing For Paracentesis

  • No food or liquids for 2 hours prior to the procedure. However, you may take all regular medications as scheduled with small sips of water.
  • It is required that you arrange for a relative or friend to drive you home after the procedure.
  • Report any medications you are taking to the radiology nurse, including “blood thinners”, such as aspirin, Plavix, Lovenox, Coumadin, Pradaxa, Xarelto, or Eliquis. Your physician may advise you to stop taking a “blood thinner” for a specific period of time before your procedure.
  • If you are taking Coumadin or heparin, or you have known or suspected liver disease, your blood will be tested to determine if your blood clots normally.
  • Report any allergies to the radiology nurse, especially those to local anesthetic medications.

The Paracentesis Procedure

  • You will be positioned lying on your back on the ultrasound table and images will be taken to locate the site of the excess fluid inside your abdomen and decide where to insert the catheter.
  • The skin of the abdomen is cleaned with an antiseptic solution and the area is covered with a large sterile sheet.
  • You will feel a slight pin prick when the local anesthetic (numbing medicine) is injected in the skin.
  • Using ultrasound as a guide, the doctor then carefully inserts the catheter through the skin into the abdomen. The catheter will fill with fluid. A tube may be attached to the catheter so that all of the excess fluid can be drained.
  • Once the fluid is drained, the catheter is removed.

Recovery From Paracentesis

  • Get plenty of rest for the remainder of the day after your procedure. You may return to light activity the day after the procedure.
  • Avoid heavy lifting or strenuous labor for 3 days after your procedure.
  • Eat and drink normally. Increased fluid intake is recommended.
  • Mild pain, discomfort, or bruising at the procedure site is expected. You may take over-the-counter Tylenol for any pain you may experience.
  • You will have a small bandage over the site. You may remove the bandage in 3 days and leave the site dry and exposed. You may shower, but do not have a tub bath for 3 days.

Call your doctor if you have any of the following:

  • Signs of infection at the procedure site, such as redness, swelling, or a fever.
  • Bleeding from the procedure site.
  • Worsening, severe pain near the procedure site.
  • More than a small amount of fluid leakage from the puncture site.
  • Fainting or feeling lightheaded.

Risks of Paracentesis

  • Bleeding at the procedure site
  • Infection at the procedure site
  • Injury to an adjacent nerve, blood vessel, muscle, or intestine
  • Fast drop in blood pressure
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