Common causes of ascites

1. Cirrhosis
2. Congestive heart failure
3. Nephrotic syndrome
4. Malnutrition
5. Infectious peritonitis
6. Cancer with peritoneal invasion

Indications of paracentesis

1. For differential diagnosis and decision making
2. For decompressing the intra-abdominal pressure and relieving the discomfort

The procedure

1. Please read the consent form and providing clear description of complications of Paracentesis for Ascites before the examination.
2. The patients usually require neither sedation or Nothing by Mouth. 
3. During the procedure, the patients should to lie down and expose their abdomen.
4. Ascites location by abdominal sonography before paracentesis.
5. After cleaning the side of the abdomen with antiseptic solutions, physicians will insert a needle along with a plastic sheath to reach the ascitic fluid.
6. The needle will be removed and, leave the plastic sheath behind to allow drainage of the fluid.
7. The physicians should monitor the discomforts of patient and the color of ascites during paracentesis.
8. After the procedure, the plastic sheath will be removed.
9. The puncture site is covered with aseptic dressings and gauze.

Aftercare

1. Monitor symptoms like dizziness and excessive pain, and patients’ vital sign.
2. Change the dressings if there is any excessive oozing from the puncture site.
3. Follow up on the abdominal circumference.