Paracentesis

Paracentesis is a procedure that uses a needle to drain fluid from the abdomen (called ascites). Ascites can be caused by other conditions, but here we will go over having a paracentesis for ascites caused by cirrhosis. If you have ascites, you may have pain, feel short of breath, or have trouble eating because your belly feels full.

If you have these symptoms, your healthcare team might suggest a paracentesis to remove a large amount of the fluid from your belly. Or, they might want to collect a fluid sample for testing.

The Procedure

Before your procedure, the doctor or nurse practitioner will check your belly for a good spot to insert the needle. They’ll do this by tapping on your belly or by ultrasound, where sound waves are used to show a picture of the fluid.  When they’ve chosen the best spot, they might put freezing medicine under your skin. This will numb the area and should make you more comfortable. You may still feel a very brief, sharp pain during the procedure.

Next, they’ll insert a needle to drain the fluid. If there’s a lot of fluid, they’ll drain it into containers connected to the needle by a small tube. They might ask you to change position to help drain the fluid more easily. When your fluid has finished draining, the team will remove the needle and bandage the spot.

If you had a lot of fluid, your doctor or nurse practitioner might prescribe a protein called albumin. You take albumin through an intravenous, or IV, which is a small tube or needle put in a vein. It lowers your risk of problems from the drainage.

You’ll likely be at the hospital anywhere from 2 hours to a full day. It depends on how much fluid you have drained and how much albumin you need.  If your fluid comes back showing you have an infection, you’ll probably be admitted to the hospital for treatment. This is not common, but it can happen.

After the Procedure

After the procedure, keep your bandage on for 24 hours. Then, you can remove it and have a shower. You can wash the needle site gently with soap and warm water.  You might feel sore for a few days, but you can go back to your normal activities unless your nurse or doctor gives you other instructions.

Some people need a paracentesis only once. Others need one every week or 2. Your healthcare team will work with you to decide how often is best for you. If you have ascites, it’s very important to eat less salt. This helps slow down the fluid buildup in your belly and give you more time until your next paracentesis.

Risks and Side Effects

Just like any medical procedure, paracentesis has risks you should know about. In rare cases, infection, bleeding, or a tear in the lining of the intestine can happen.

If you get belly pain, fever, bleeding, or fluid is leaking from the needle site, call your doctor or nurse or go to the emergency department right away.

References:

The information on this page was adapted (with permission) from the references below, by the Cirrhosis Care Alberta project team (physicians, nurse practitioners, registered nurses, registered dietitians, physiotherapists, pharmacists, and patient advisors).

This information is not intended to replace advice from your healthcare team. They know your medical situation best. Always follow your healthcare team’s advice.

References: 

  1. US Department of Veterans Affairs, Veterans Health Administration 
  2. Canadian Liver Foundation
Last reviewed March 15, 2021
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