Paracentesis

Abdominal paracentesis is performed as a diagnostic procedure to establish the etiology of new-onset ascites or to rule out spontaneous bacterial peritonitis in patients with preexisting ascites. Large-volume paracentesis is performed in hemodynamically stable patients with tense or refractory ascites to alleviate discomfort or respiratory compromise. Contraindications Many patients undergoing paracentesis will have baseline coagulopathy or thrombocytopenia. However, the incidence of clinically significant bleeding during paracentesis is extremely low, and routine use of fresh-frozen plasma or platelet concentrates is not recommended. Paracentesis should be avoided in patients with disseminated intravascular coagulation

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