Paracentesis (Abdominal Tap): Procedure Steps, Indications, and Aftercare

Paracentesis (abdominal tap) is a procedure to remove excess peritoneal fluid (ascites) via needle insertion. It relieves symptoms and aids diagnosis.

Indications

• Symptomatic ascites: abdominal pain, distension, dyspnea, early satiety.
• Diagnostic: new-onset ascites, suspected infection (SBP), malignancy.
• Therapeutic: large-volume removal for comfort.

Procedure Overview (Typical Steps)

1. Consent & Preparation: Explain risks/benefits; position supine; clean skin; local anesthetic (lidocaine).
2. Ultrasound Guidance: Standard of care to locate fluid, avoid organs/vessels.
3. Needle/Catheter Insertion: Z-track technique often used; advance to fluid pocket.
4. Fluid Drainage: Connect to vacuum bottle or syringe; drain slowly (≤1 L at a time if no albumin) to prevent hypotension.
5. Monitoring: Vital signs throughout; assess for complications.
6. Sample Collection: Send for cell count, culture, albumin, cytology, amylase as indicated.
7. Dressing & Post-Care: Sterile dressing; monitor for leakage, bleeding, infection; activity restriction briefly.

Complications (Rare)

Bleeding, bowel perforation, infection, hypotension, electrolyte shifts, persistent leak.

Performed by trained clinicians (gastroenterology, radiology, surgery) in appropriate settings.