Paracentesis to treat ascites caused by cirrhosis

Paracentesis is a procedure that uses a needle inserted into the abdominal cavity to remove fluid (ascites) that collects in the abdomen. Paracentesis can help a doctor determine the cause of ascites and diagnose infection in the fluid (diagnostic paracentesis). It can also be used to treat ascites (therapeutic paracentesis) and prevent the problems associated with it.

Therapeutic paracentesis may be used if you have cirrhosis and you:

• Have severe ascites that is causing extreme discomfort, including abdominal pain and difficulty breathing (tense ascites). A one-time paracentesis treatment may relieve the discomfort of tense ascites before you begin treatment with one or more diuretics.
• Have not responded to standard treatment with diuretic medication and a low-salt diet. (This is the case in fewer than 10% of people who have ascites.)¹

Although paracentesis is faster than diuretic medication at removing fluid from the abdominal cavity, it is not the preferred treatment option for people who have ascites caused by cirrhosis. Removing large amounts of fluid at once can cause complications, including low blood pressure and kidney failure. If large amounts of fluid have been removed from your abdomen, you should be given an infusion of protein (albumin) to help prevent decreased kidney function (renal insufficiency).

If you have had paracentesis to quickly relieve ascites, you still have to restrict your salt intake, take diuretics, and stop drinking alcohol to help prevent the fluid from building up again.

Citations

1. Runyon BA (2002). Ascites and spontaneous bacterial peritonitis. In M Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 7th ed., vol. 2, pp. 1517–1540. Philadelphia: W.B. Saunders.