Paracentesis: Difference between revisions

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==Procedure==
==Procedure==
[[Image:Gray-image522.gif|right|thumb|350px|{{#ifexist:Template:Gray-image522.gif/credit|{{Gray-image522.gif/credit}}<br/>|}}The location of the inferior epigastric artery within the sheath of the rectus muscle.]]
{{Image|Gray-image522.gif|right|350px|The location of the inferior epigastric artery within the sheath of the rectus muscle.}}
If a lower quadrant is used, inserting the needle lateral to the rectus muscle will avoid the inferior hypogastric artery.
If a lower quadrant is used, inserting the needle lateral to the rectus muscle will avoid the inferior hypogastric artery.



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A paracentesis is a medical "procedure in which fluid is withdrawn from a body cavity via a trocar and cannula, needle, or other hollow instrument."[1][2][3] A paracentesis usually refers to removing ascites.

Procedure

The location of the inferior epigastric artery within the sheath of the rectus muscle.

If a lower quadrant is used, inserting the needle lateral to the rectus muscle will avoid the inferior hypogastric artery.

Routine ultrasonography can increase success rates according to a randomized controlled trial.[4]

If more than 5 liters of acites are removed, consider giving 6.25 g of albumin for each liter over 5 liters.[5]

Interpretation of results

Cell count

Albumin

  • A serum-ascites albumin gradient (SAAG) of less than 1.1 g/dL lowers the probability of portal hypertension.[2]

Protein

Ph

Cultures

References

  1. Anonymous (2024), Paracentesis (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. 2.0 2.1 2.2 Wong CL, Holroyd-Leduc J, Thorpe KE, Straus SE (March 2008). "Does this patient have bacterial peritonitis or portal hypertension? How do I perform a paracentesis and analyze the results?". JAMA 299 (10): 1166–78. DOI:10.1001/jama.299.10.1166. PMID 18334692. Research Blogging.
  3. Thomsen TW, Shaffer RW, White B, Setnik GS (November 2006). "Videos in clinical medicine. Paracentesis". N. Engl. J. Med. 355 (19): e21. DOI:10.1056/NEJMvcm062234. PMID 17093242. Research Blogging.
  4. Nazeer SR, Dewbre H, Miller AH (May 2005). "Ultrasound-assisted paracentesis performed by emergency physicians vs the traditional technique: a prospective, randomized study". Am J Emerg Med 23 (3): 363–7. PMID 15915415[e]
  5. Ginès P, Titó L, Arroyo V, et al (June 1988). "Randomized comparative study of therapeutic paracentesis with and without intravenous albumin in cirrhosis". Gastroenterology 94 (6): 1493–502. PMID 3360270[e]