What is an ascites puncture?
During an ascites puncture, the doctor uses a hollow needle or cannula to remove fluid that has accumulated in the abdominal cavity. As new or increasing ascites (“ascites”) is usually a sign of a serious illness, the cause must be found as quickly as possible (diagnostic puncture). Analysis of the fluid removed can provide valuable information.
Ascites can also cause so much discomfort that draining large amounts of fluid by means of a puncture can be very relieving (therapeutic puncture).
When is an ascites puncture performed?
Ascites can have many different causes, for example peritonitis or cancer. Other diseases that can lead to ascites are, for example
- Liver cirrhosis
- Occlusion of the liver vessels
- Functional weakness of the right side of the heart (right heart failure) or the entire heart muscle (global heart failure) – more on this in the text Heart failure (cardiac insufficiency)
- Inflammation of the pericardium (pericarditis)
- Pancreatitis (inflammation of the pancreas)
- Albumin deficiency (hypalbuminemia), for example due to malnutrition
- Lymphatic drainage disorders
However, not every ascites needs to be punctured. As a general rule, a new accumulation of fluid within the peritoneum should always be punctured in order to determine the cause by analyzing the fluid removed.
A puncture is also advisable for patients with known ascites whose condition is worsening or whose fluid accumulation is increasing.
What is done during an ascites puncture?
The further procedure depends on whether the ascites puncture is performed for diagnostic or therapeutic purposes.
Diagnostic ascites puncture: procedure
To assess the accumulated fluid, the doctor only needs a small amount of it: he carefully sticks a hollow needle through the abdominal wall into the abdominal cavity and draws up a sample of the fluid collected there using a syringe. This sample is then examined in the laboratory for color, cell count, protein content, bacteria and many other parameters.
Therapeutic ascites puncture: procedure
What are the risks of an ascites puncture?
A purely diagnostic ascites puncture is a very safe procedure and carries hardly any risks for the patient. Ascites drainage for therapeutic purposes, on the other hand, has a higher complication rate. Possible dangers are
- persistent leakage of fluid through the puncture channel
- Infections of the peritoneum (peritonitis)
- Abdominal wall abscess
- bleeding
- Injury to surrounding structures and organs during puncture
What should I be aware of after an ascites puncture?
If you have been given a sedative for the ascites puncture, your ability to drive will be temporarily significantly impaired. If you are not staying in hospital anyway, you should organize someone to pick you up in advance.
