Paracentesis

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Intervention:
Paracentesis
ICD-10 code:
ICD-9 code: 54.91
Other codes:

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Articles on Paracentesis in N Eng J Med, Lancet, BMJ

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Overview

Paracentesis is a medical procedure used for a number of reasons:

Paracentesis for Ascites

The procedure is often done in doctors 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 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 10 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 very 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.[1] The risk of bleeding may be increased if:[2]

References

  1. McVay PA, Toy PT (1991). "Lack of increased bleeding after paracentesis and thoracentesis in patients with mild coagulation abnormalities". Transfusion. 31 (2): 164–71. PMID 1996485.
  2. Ginès P, Cárdenas A, Arroyo V, Rodés J (2004). "Management of cirrhosis and ascites". N. Engl. J. Med. 350 (16): 1646–54. doi:10.1056/NEJMra035021. PMID 15084697.

External links

Cost Effectiveness of Paracentesis

| group5 = Clinical Trials Involving Paracentesis | list5 = Ongoing Trials on Paracentesis at Clinical Trials.govTrial results on ParacentesisClinical Trials on Paracentesis at Google


| group6 = Guidelines / Policies / Government Resources (FDA/CDC) Regarding Paracentesis | list6 = US National Guidelines Clearinghouse on ParacentesisNICE Guidance on ParacentesisNHS PRODIGY GuidanceFDA on ParacentesisCDC on Paracentesis


| group7 = Textbook Information on Paracentesis | list7 = Books and Textbook Information on Paracentesis


| group8 = Pharmacology Resources on Paracentesis | list8 = AND (Dose)}} Dosing of ParacentesisAND (drug interactions)}} Drug interactions with ParacentesisAND (side effects)}} Side effects of ParacentesisAND (Allergy)}} Allergic reactions to ParacentesisAND (overdose)}} Overdose information on ParacentesisAND (carcinogenicity)}} Carcinogenicity information on ParacentesisAND (pregnancy)}} Paracentesis in pregnancyAND (pharmacokinetics)}} Pharmacokinetics of Paracentesis


| group9 = Genetics, Pharmacogenomics, and Proteinomics of Paracentesis | list9 = AND (pharmacogenomics)}} Genetics of ParacentesisAND (pharmacogenomics)}} Pharmacogenomics of ParacentesisAND (proteomics)}} Proteomics of Paracentesis


| group10 = Newstories on Paracentesis | list10 = Paracentesis in the newsBe alerted to news on ParacentesisNews trends on Paracentesis


| group11 = Commentary on Paracentesis | list11 = Blogs on Paracentesis

| group12 = Patient Resources on Paracentesis | list12 = Patient resources on ParacentesisDiscussion groups on ParacentesisPatient Handouts on ParacentesisDirections to Hospitals Treating ParacentesisRisk calculators and risk factors for Paracentesis


| group13 = Healthcare Provider Resources on Paracentesis | list13 = Symptoms of ParacentesisCauses & Risk Factors for ParacentesisDiagnostic studies for ParacentesisTreatment of Paracentesis

| group14 = Continuing Medical Education (CME) Programs on Paracentesis | list14 = CME Programs on Paracentesis

| group15 = International Resources on Paracentesis | list15 = Paracentesis en EspanolParacentesis en Francais

| group16 = Business Resources on Paracentesis | list16 = Paracentesis in the MarketplacePatents on Paracentesis

| group17 = Informatics Resources on Paracentesis | list17 = List of terms related to Paracentesis


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