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Drainage of abdominal fluid (abdominal paracentesis)

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This leaflet is designed to explain what happens when someone requires abdominal paracentesis. If you have any questions or concerns, please speak to your doctor or nurse.

What is ascites?

Ascites is the medical term used to describe the build up of fluid inside the abdominal cavity (tummy). In a healthy person, the body normally produces a small amount of fluid in the abdomen; this is constantly produced and reabsorbed. However, in certain conditions such as liver disease or cancer, there is an imbalance of fluid production and absorption and this causes too much fluid to build up in the abdomen.

What are the symptoms of ascites?

  • Abdominal swelling.
  • Abdominal discomfort/pain.
  • Shortness of breath.
  • Fatigue.
  • Nausea and vomiting.
  • Indigestion.
  • Poor appetite.
  • Reduced mobility.
  • Constipation or diarrhoea.

How can we manage ascites?

We can ease some of the symptoms of ascites by removing the excess fluid in the abdomen. We can do this by:

  • Medications called diuretics (water tablets)
  • Inserting a temporary plastic tube into the abdomen to drain off the excess fluid (abdominal paracentesis).

Abdominal paracentesis usually provides immediate relief of symptoms. Diuretics can take longer to work and can have side effects. People with ascites often require both medications and drainage to manage their symptoms.

What happens during the abdominal paracentesis procedure?

  • Before your procedure, a small plastic tube called a cannula or ‘drip’ will be inserted into a vein. This is typically in your arm or back of your hand. This is needed to give you some Albumin (one of the body’s proteins) via the cannula during the procedure, which reduces complications of the procedure.
  • You will be required to lie on a bed and the Doctor or Nurse will examine you and decide where the best place to insert the drain will be. Sometimes an ultrasound machine may need to be used. This is usually in the right or left lower part of your abdomen.
  • Once the appropriate site for the drain is chosen, the Doctor or Nurse will put on sterile gowns and gloves and the site on your abdomen is thoroughly cleaned.
  • A small injection of local anaesthetic is given to numb the area where the drain is to be inserted.
  • After the anaesthetic has started to work, a very small cut is made into the skin and a thin tube is inserted through the cut into the abdominal cavity.
  • The tube is attached to a drainage bag to collect the fluid.
  • Some of the fluid will be sent to the lab for analysis and the results of this will be available later that day.
  • The tube is fastened to the skin with sticky dressings. Your nurse will do regular observations on you including your blood pressure, heart rate and temperature.
  • The drain will typically stay in for no longer than 6 hours OR for 12 litres of fluid to drain (whichever is sooner).
  • The fluid drained is usually replaced at the same time with the Albumin solution through the ‘drip’.
  • It is safe for the procedure to be performed whilst on low molecular weight heparin.

Drainage of abdominal fluid

What happens after the procedure?

After the fluid has drained you will be asked to lie on the bed and the nurse will remove the drain which is quick and painless. A waterproof dressing will be placed over the area and should be kept in place and dry for 48 hours. Your cannula will be removed.

What are the risks of the procedure?

Abdominal paracentesis is a safe procedure with a very small rate of significant complications (less than 1 in 1000 people).

Some of the common risks are:

  • Lethargy
  • Slight increase in abdominal discomfort
  • Leakage from the drain site (for up to 3 days after the procedure).
  • Failure to drain fluid.

Rarer complications are:

  • Infection of the skin/abdominal cavity
  • Bleeding
  • Low blood pressure
  • Damage to internal organs (bowel/liver/spleen).

Can I go home after the procedure?

The procedure is carried out as a day case for most patients. Rarely, you may need to be admitted to the ward if you develop complications. Once the drain is taken out and you feel well, you should be able to return home.

What follow up will I have?

After the procedure the Doctor will let you know if you need to come back to be seen again, or have blood tests with your GP. It is important to know that the fluid in your abdomen may build up again and the procedure may need to be repeated.

What should I do if I experience problems after the procedure?

If you feel feverish, unwell, notice redness, swelling or pain around the drain site or if you have any other concerns, please seek medical attention.

You can either contact your GP during working hours or attend your local A&E department.

Contact Information

For more information about abdominal paracentesis or the contents of this leaflet, please ask the doctor or nurse performing your procedure.

Useful Contact Number:
Acute Ambulatory Unit 01273 696955 (Extensions: 64608, 64174, or 67511)

This leaflet was produced on behalf of the Departments of Acute Medicine and Digestive Diseases at The Royal Sussex County Hospital, Eastern Road, Brighton, East Sussex BN2 5BE.

Authors: Dr M Austin and Dr D E Rangedara

This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.

The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

Publication Date: July 2019

Review Date: January 2023

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