Paracentesis

Paracentesis

Interventions infobox
Name = Paracentesis


ICD10 =
ICD9 = 54.91
OtherCodes =
Paracentesis is a medical procedure involving needle drainage of fluid from a body cavity, most commonly the abdomen. It is used for a number of reasons:
* to relieve abdominal pressure from ascites
* to diagnose spontaneous bacterial peritonitis and other infections (e.g. abdominal TB)
* to diagnose metastatic cancer
* to diagnose blood in peritoneal space in trauma
* to puncture the tympanic membrane for diagnostic purposes, such as taking a bacterial swab from the middle ear.

A related procedure is thoracocentesis, which is needle drainage of the chest cavity.

Paracentesis for Ascites

The procedure is often done in a doctor's office or an out-patient clinic. In an expert's hands, it is very safe, although there is a very small risk of introducing an infection, causing excessive bleeding or perforating a loop of bowel.

During the procedure, patients are asked to lie down and expose their abdomen. After cleaning the side of the abdomen with an antiseptic solution, physicians will numb a small area of skin and then insert a fairly large-bore needle (along with a plastic sheath) 2 to 5 cm to reach the peritoneal (ascitic) fluid. The needle is then removed, leaving the plastic sheath behind to allow drainage of the fluid. The fluid can be drained by gravity or by connection to a vacuum bottle. Up to 11 litres of fluid may be drained during the procedure. If fluid drainage is more than 5 litres, patients may receive intravenous serum albumin (25% albumin, 8g/L) to prevent hypotension (low blood pressure).

The procedure generally is not painful; patients require no sedation. As long as they are not too dizzy and maintain their blood pressure after the procedure, they can go home afterwards.

Ascitic fluid analysis

The serum-ascities albumin gradient can help determine the cause of the ascites.The ascitic white blood cell count can help determine if the ascites is infected.

Contraindications

Mild hematologic abnormalities do not increase the risk of bleeding.cite journal |author=McVay PA, Toy PT |title=Lack of increased bleeding after paracentesis and thoracentesis in patients with mild coagulation abnormalities |journal=Transfusion |volume=31 |issue=2 |pages=164–71 |year=1991 |pmid=1996485 |doi=10.1046/j.1537-2995.1991.31291142949.x] The risk of bleeding may be increased if:cite journal |author=Ginès P, Cárdenas A, Arroyo V, Rodés J |title=Management of cirrhosis and ascites |journal=N. Engl. J. Med. |volume=350 |issue=16 |pages=1646–54 |year=2004 |pmid=15084697 |doi=10.1056/NEJMra035021]
* prothrombin time > 21 seconds
* international normalized ratio > 1.6
* platelet count < 50,000 per cubic millimeter.

References

External links

* [http://note3.blogspot.com/2004/02/paracentesis-procedure-guide.html Paracentesis - a step-by-step procedure guide] . Clinical Notes.
* WebMD: [http://my.webmd.com/hw/brain_nervous_system/hw198220.asp Patient guide]


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Look at other dictionaries:

  • paracentesis — f. cirug. Punción quirúrgica de una cavidad (pleural, peritoneal, tímpano, pericardio, etc.) generalmente realizada para eliminar líquido acumulado. Medical Dictionary. 2011. paracentesi …   Diccionario médico

  • paracentesis — (plural paracentesis) sustantivo femenino 1. Área: medicina Pinchazo en una cavidad del cuerpo humano para extraer el líquido que contiene …   Diccionario Salamanca de la Lengua Española

  • paracentesis — (Del lat. paracentēsis, y este del gr. παρακέντησις). f. Med. Punción que se hace en el vientre para evacuar la serosidad acumulada anormalmente en la cavidad del peritoneo …   Diccionario de la lengua española

  • Paracentesis — Par a*cen*te sis (p[a^]r [.a]*s[e^]n*t[=e] s[i^]s), n. [L., fr. Gr. parake nthsis, fr. parakentei^n to pierce at the side, to tap.] (Med.) The perforation of a cavity of the body with a trocar, aspirator, or other suitable instrument, for the… …   The Collaborative International Dictionary of English

  • paracentesis — (n.) 1590s, from Gk. parakentesis, from parakentein to pierce at the side, from para beside (see PARA (Cf. para )) + kentein to prick, stab (see CENTER (Cf. center)) …   Etymology dictionary

  • Paracentesis — La paracentesis es un procedimiento médico caracterizado por punción quirúrgica hecha en una cavidad orgánica para evacuar la serosidad acumulada. En el interior del abdomen, en la cavidad peritoneal, se acumula en ocasiones líquido. La… …   Wikipedia Español

  • paracentesis — ► sustantivo femenino MEDICINA Punción que se realiza en el vientre para evacuar la serosidad acumulada de forma anormal en el peritoneo. IRREG. plural paracentesis * * * paracentesis (del lat. «paracentēsis», del gr. «parakéntēsis») f. Cir.… …   Enciclopedia Universal

  • Paracentesis — The removal of fluid from a body cavity using a needle, trocar, cannula, or other hollow instrument. A paracentesis may be diagnostic or therapeutic as, for example, in ascites where there is free fluid in the abdominal (peritoneal) cavity. If… …   Medical dictionary

  • paracentesis — {{＃}}{{LM P29022}}{{〓}} {{［}}paracentesis{{］}} ‹pa·ra·cen·te·sis› {{◆}}(pl. paracentesis){{◇}} {{《}}▍ s.f.{{》}} {{♂}}En medicina,{{♀}} punción en una cavidad del cuerpo con una aguja hueca para evacuar el líquido acumulado.… …   Diccionario de uso del español actual con sinónimos y antónimos

  • paracentesis — /par euh sen tee sis/, n., pl. paracenteses / seez/. Surg. puncture of the wall of a cavity to drain off fluid. Also called tapping. [1590 1600; < L paracentesis perforation, tapping < Gk parakéntesis, equiv. to parakente , var. s. of parakenteîn …   Universalium

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