Prof. Dr. Rahmi Çubuk

Drenajlar

Drenajlar

Paracentesis

What is Paracentesis ?
In some diseases, fluid can accumulate between the layers of the membranes surrounding the abdominal organs (peritoneum). The most common causes of fluid buildup include heart and kidney failure, liver diseases, and certain tumors. Excess fluid in the abdomen can lead to swelling and respiratory distress due to pressure on the diaphragm.

Preventing fluid accumulation within the abdomen depends on treating the underlying disease. However, to alleviate symptoms such as swelling, paracentesis is performed to drain the excess fluid during the treatment of the underlying condition.

Paracentesis is typically done under ultrasound guidance, where fluid within the abdomen is visualized. A catheter is inserted through the skin to drain the fluid.

The Purpose of Paracentesis :

  • To relieve symptoms such as swelling, constipation, and breathing difficulties
  • To use the collected fluid as a diagnostic tool (to determine the properties of the fluid)

How Will I Benefit from Paracentesis ?
Paracentesis helps reduce abdominal swelling caused by fluid buildup, improving circulation and respiratory function. You will feel more comfortable after the procedure. Additionally, the fluid that is removed is often sent to a pathology laboratory, assisting in diagnosing the underlying disease.

What Should I Do Before the Paracentesis Procedure ?
Before the procedure, you should inform your doctor of all the medications you are taking, and let them know if you have any allergies. Your doctor may ask you to stop taking blood-thinning medications such as aspirin for a certain period before the procedure. Other medications (e.g., insulin) may also require adjustments.

Blood tests may be necessary before the procedure. You may also be asked not to eat or drink for 6-8 hours prior to the procedure. If you’re having the procedure on an outpatient basis, ensure you have a relative or friend to accompany you home afterward.

How Is the Paracentesis Procedure Performed ?
The procedure is performed by an interventional radiologist, who will use imaging techniques such as ultrasound, CT, fluoroscopy, or a combination of these to find the safest and shortest path to the fluid collection.

After identifying the entry point, your skin will be cleaned and sterilized. Local anesthetics will be applied under your skin. If necessary, a small incision (3-4 mm) will be made to allow the tube to pass. Then, a hollow needle is inserted through the skin to the fluid collection site, and a guidewire is passed through the needle to the collection. Once the needle is withdrawn, the catheter is placed over the guidewire. Finally, the guidewire is removed.

The catheter is connected to a small drainage bag outside the body, allowing the fluid to drain from the catheter into the bag. The catheter is secured in place with adhesive bands or stitches to prevent it from moving. The entry site is covered with dressings.

What Are the Risks ?
Paracentesis is a safe procedure with a low risk of complications when guided by imaging techniques. However, in rare cases, abdominal organs or blood vessels may be damaged. There is also a very small chance that bacteria could enter the bloodstream, leading to septic shock. If this happens, it can be treated with intravenous antibiotics and other medications.

How Do I Care for the Drain and Dressing? What is the Follow-Up Plan ?
When discharged, you will receive instructions on how to empty and change the drainage bag, clean the catheter, and when to seek emergency medical attention. You may also need to take antibiotics after the procedure.

The paracentesis catheter can be removed immediately or may stay in place for weeks, depending on the progress of your treatment. At the appropriate time, the catheter will be removed with a simple procedure.

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