Ascitic Tap (Paracentesis) in Lucknow

Ascites is fluid that builds up inside the abdomen, between the lining of the belly and the organs. It makes the abdomen swell and feel tight. It can cause breathlessness, a feeling of fullness after eating very little and discomfort when lying down.

It has several causes, including liver disease, heart or kidney problems, infection and cancer. Finding the cause matters, because the treatment differs. An ascitic tap, also called paracentesis, passes a needle or a thin tube through the abdominal wall to remove fluid.

Not everyone with ascites needs a tap. Mild ascites is often managed with medicines and diet advice from your doctor. A tap is considered when the fluid needs testing or is causing distress.

A diagnostic tap takes a small sample, enough for the laboratory. It is quick. It is often done when ascites is found for the first time. It is also done when a person with ascites develops fever or belly pain, because infection of the fluid needs urgent treatment.

A therapeutic tap, which means draining for relief, removes much more fluid, sometimes several litres, to ease pressure and breathlessness. The fluid drains slowly through a thin tube into a bottle or bag. It takes longer, and your pulse and blood pressure are checked. After a large drain, doctors sometimes give a drip of albumin, a blood protein, to protect the circulation.

Ultrasound is used first to find a pocket of fluid and a safe spot, usually low on the side of the belly, away from the bowel and blood vessels. A walled-off pocket of infected fluid is treated differently, with a tube left in place, as described under PCD.

Whether a large drain can be done at the centre or must be done elsewhere is decided after the team reads your referral, scans and blood reports.

Your doctor decides which tests to order. The common ones are:

• Cell count: the number of white cells. A high count can mean the fluid is infected.
• Protein and albumin: compared with a blood albumin test taken the same day, these help show whether the cause lies in the liver, the heart or elsewhere.
• Culture: whether bacteria grow, and which antibiotics would work against them.
• Cytology: a pathologist looks for abnormal cells, which can point to cancer.
• Tests for tuberculosis, where your doctor suspects it.

The results go to the doctor who ordered the tests, who explains what they mean alongside the rest of your history. The team will tell you when to expect the reports. Blood tests taken on the same day can be done at our pathology lab.

An ascitic tap is a common procedure, and serious problems are uncommon. The risks are:

• Leakage of fluid through the needle hole, which usually stops with a dressing.
• Bleeding in the belly wall, mostly small, and more likely if you have a clotting problem.
• Infection of the skin or of the fluid.
• A fall in blood pressure, dizziness or strain on the kidneys after a large drain.
• Injury to the bowel or bladder, which is rare. This is why you empty your bladder first and why ultrasound picks the spot.

A tap treats the symptom, not the cause. If the cause continues, the fluid usually returns, and repeat taps may be needed. Your doctor treats the cause alongside.