2009 Abdominal Paracentesis (Tap)
What is an Abdominal Paracentesis (Tap)? A needle and/or thin, hollow plastic tube, is placed into the belly to remove some fluid. Some diseases, such as liver disease in its later stages, cancer and certain infections may cause a build up of fluid inside the belly. A larger than normal amount of fluid in the belly is also called ascites. Why do I need this treatment? When the cause of the build up of fluid is not known, getting a sample of the fluid can help in reaching an answer. The most usual reasons for doing a paracentesis are: First time fluid build up in the belly (ascites) - The fluid sample may give helpful facts to your doctor to diagnose the cause of the ascites. Infection - If infection is suspected, paracentesis may be done to help make a diagnosis. Cancer - Some cancers can spread and cause a build up of fluid in the belly. Paracentesis may be the simplest way to get a sample of cancer cells to make a diagnosis instead of doing surgery to get a tissue sample. Comfort - If a large amount of fluid is in your belly, this treatment may make you feel more comfortable. 1
What do I need to do before the treatment? Be sure to tell your doctor about all medicines that you are taking like: a) Blood thinners (anticoagulants) such as ASA (aspirin), warfarin, fragmin or heparin. b) Any Non-Steroidal Anti- Inflammatory Drugs such as medicines for pain, arthritis, gout, migraine, nerve pain or high uric acid in the blood. c) Plavix (helps avoid a stroke or heart attack). What happens on the day of the treatment? Your doctor will talk with you about the risks of having this treatment and all of your questions about the treatment will be answered. Do not wear any jewellery or bring valuables to the hospital. You will be asked to drain your bladder before the treatment. Where is the treatment done? This treatment may be performed on the hospital ward, in the emergency department, in outpatient clinics or in the Medical Day Unit. 2
If you have a booked visit at the Medical Day Unit please go to the 4 th floor, Victoria Building, Victoria General site. Check-in with the clerk at the desk when you get there. How is the treatment done? A nurse will get you ready for the treatment. The nurse will check your health history and the medicines you take. You will have your blood pressure and weight recorded before the treatment. You will be given a gown to wear. You will be asked to lie on your side on the bed or stretcher. The doctor will wipe your belly with a cleaning mixture. Freezing may be given into the area on your belly where the needle or catheter will be placed. You might feel some burning at the spot where you get the freezing. Your doctor will put a needle or hollow plastic tube into your belly. Tubing will be joined to the needle or hollow tube so that fluid will run into a drainage bag or glass bottle. 3
It is good idea to lie very still during the treatment to lessen the chance of the needle or catheter moving. You will stay joined to the drainage tubing until fluid stops draining or your doctor decides the right amount of fluid has drained off. If the fluid draining stops too soon, you may be asked to change your position on the bed or the doctor may change the angle of the needle or catheter. It is hard to know exactly how long the treatment will take, but plan on being with us for one to two hours. Pressure will be put on the spot where the needle or catheter was removed. A gauze bandage will then be put on. Your blood pressure will be checked during and after the treatment. You will be weighed again after the tap and your weight will be recorded. What do I do after the treatment? You must not do any strenuous activity [like play sports] for 24 hours. Do not lift anything over 30 pounds. Please arrange to have someone drive you home as you may have some light-headedness after the treatment. To avoid leakage at the site, do not sleep/lay 4
on the side where the tap was done for 24 hours. You may go back to your normal activities 24 hours after the treatment. You may go home with a small gauze dressing over the spot where the tap was done. This can be removed after 24 hours if no leaking has taken place. If leaking does happen, remove the dressing, put on pressure for five minutes and replace the dressing. Continue to avoid sleeping/lying on the side where the tap was done. If fluid samples were sent to the lab, talk to your doctor about how you will find out the results of the tests. What are some problems that can come about with this treatment? With up to date techniques, paracentesis is considered a safe treatment. Some bleeding disorders may make the treatment too unsafe to do. Pregnancy, abnormally enlarged organs, severe bowel or bladder swelling and past belly or pelvic surgery may add to the chance of something going wrong. Problems are rare with this treatment but can include: Constant leaking of fluid from the spot where the tap was done. A drop in blood pressure if a large amount of fluid is removed. Your doctor may treat your low blood pressure with an intravenous infusion of Albumin or 5
change your diuretic medicine (water pill) for a few days after the treatment. Fainting and or light-headedness (dizziness) as a result of low blood pressure. Infection where the needle or catheter was put in. Bleeding. Infection inside the belly cavity (peritonitis). Injury to belly organs (i.e. bladder, bowel). Call your doctor if any of these things happen: Swelling, redness or sore feeling in the area where the tap was done that lasts longer than a few days after the treatment. Chills, fever (more than 38.0 C or 100 F). New or increasing belly pain. Bleeding from the spot where the tap was done. Leaking from the spot where the tap was done that lasts for more than 48 hours after your tap. Blood in urine. 6
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Looking for more health information? Contact your local public library for books, videos, magazine articles and online health information. For a list of public libraries in Nova Scotia go to HTTP://publiclibraries.ns.ca Capital Health promotes a smoke-free and scent-free environment. Please do not use perfumed products. Thank you! Capital Health, Nova Scotia www.cdha.nshealth.ca Prepared by: Paula Hammond CNE, Liver Care Committee, GI Medicine, Capital Health Illustrations by: Pages???? - LifeART Health Care 1 Images; Pages?? - LifeART Super Anatomy 1 Images, Copyright 1994, TechPool Studios Corp. USA Designed and Printed by: QEII Audio Visual and Printing Departments WI85-1219 Created June 2009 The information in this pamphlet is to be updated every 3 years.