ASCITES TAPPING(PARACENTESIS)
Ascites Tapping(paracentesis)
Ascites tapping is a procedure to remove excess fluid from the abdominal cavity with the help of the needle. Excess fluid in the abdomen is called “ascites” Normally, there is no ascites. The most common reason of ascites is a liver condition known as cirrhosis. Other causes are Tuberculosis, cancer, pancreas, heart or kidney diseases.
Our area of clinical expertise include:
Diagnostic
❖ To determine the etiology
❖ To detect cancerous cells
❖ To diagnose spontaneous or secondary bacterial peritonitis
Therapeutic
Procedure
It may be done with or without sonography guidance depending upon the patient condition and the indication. A site is selected on right or left lower abdomen. It is cleaned with anti-bacterial solutions and then punctured with needle in a zigzag fashion. Around 20-30 ml of ascitic fluid collected in a sterilized container and sent to laboratory for evaluation. If it is a therapeutic tapping, ascitic fluid in multiples of liters is removed. Albumin injection is given if the fluid removed is in excess of 5 liters. Once the procedure is done, the needle is removed and the punctured site is sealed with a tape.
Patients with advanced cirrhosis of liver may need to undergo paracentesis repeatedly.
Complications
It is a relatively safe procedure. Complication rate is less than 1%.
❖ Paracentesis leak
❖ Bleeding
❖ Infection
❖ Bowel perforation
❖ Hyponatremia
❖ Renal dysfunction
❖ Hepatic encephalopathy
The need for repeated paracentesis in a patient with liver cirrhosis is an indication of liver transplantation.
Anorectal disorders:
❖ Constipation
❖ Fecal Incontinence
❖ Proctalgia Fugax
❖ Pruritus Ani
Hepato-biliary disorders:
❖ Jaundice
❖ Liver disease like viral hepatitis, alcoholic hepatitis, Auto-immune hepatitis, drug induced liver injury
❖ Cirrhosis of liver due to chronic viral hepatitis, Alcoholic and non-alcoholic fatty liver diseases, Primary biliary cholangitis, primary sclerosing cholangitis,
❖ End stage liver disease
❖ Biliary diseases like bile duct stone disease, malignancies etc.
Pancreatic disorders:
❖ Acute pancreatitis
❖ Chronic pancreatitis
❖ Pancreatic duct stones
❖ Pancreatic malignancy and cystic disease
DEPT OF MEDICAL GASTROENTEROLOGY
DR. K. K. RAWAL (MD, DM – GASTRO)
DR. AVVAL K. SADIKOT (MD, DNB-GASTRO)
DR. CHINTAN H. KANSAGRA (MD,DNB – GASTRO)
DR. CHINTAN M. MORI (MD,DNB – GASTRO)
