Paracentesis
Formal Definition
A procedure in which a needle or catheter is inserted through the abdominal wall to aspirate ascitic fluid from the peritoneal cavity; used diagnostically (to evaluate new-onset ascites or rule out spontaneous bacterial peritonitis) or therapeutically (large-volume paracentesis for tense ascites relief).
How It's Used on the Ward
"Para" or "tapped" or "doing a tap" — standard on hepatology and medicine floors; "tap the belly" when ascites is causing discomfort or respiratory compromise.
Example
""Tense ascites — patient can barely breathe. Large-volume para: 8 liters of straw-colored fluid removed over 90 minutes. Gave albumin 8 g per liter removed (64 g IV) to prevent post-para circulatory dysfunction. Sent cell count, culture, albumin, and protein on the fluid.""
Clinical Context
Diagnostic tap: always send cell count + differential (PMN >250 cells/μL = SBP), culture (inoculate in blood culture bottles at bedside), ascitic albumin (for SAAG = serum albumin − ascitic albumin: SAAG ≥1.1 = portal hypertension, <1.1 = non-portal cause). Large-volume para (>5L): requires albumin infusion (8g per liter removed) to prevent type 1 hepatorenal syndrome. Ultrasound guidance improves safety. Relative contraindication: INR >2 or platelets <25k — discuss with proceduralist.