37. Ascites, abdominocentesis

Question 1

37. Ascites, abdominocentesis

Answer 1

Abdominocentesis
-ascites–abnormal accumulation of fluid(trauma-associated:blood/septic exudate/urine/bile/chyle)in the peritoneal cavity
-abdominocentesis may be performed with or without(blind)ultrasound guidance in case of ascites
-ultrasound guidance usually the preferred option–only confirmed fluid pockets are punctured
-open/closed technique,similar equipment as for thoracocentesis
-fluid always collected and analyzed!

Ascites

Blind abdominocentesis
-to avoid splenic injury,abdominocentesis is most commonly
performed in left lateral recumbency
-using an aseptic technique,an over-the needle catheter,butterfly
catheter,or hypodermic needle is introduced 1–3 cm caudal to the umbilicus and just to the left of midline
-a single negative abdominocentesis mandates a four-quadrant
peritoneal tap when paired with high clinical suspicion of abdominal
effusion