We present two cases of umbilical hernia incarceration following large volume paracentesis (LVP) in patients with cirrhotic ascites. Both patients became symptomatic within 48 hours after the LVP. [ncbi.nlm.nih.gov]

• Ascites

  A value higher than 0.002 is regarded as exudative ascites, whereas a value lower than 0.002 is regarded as transudative ascites. [emedicine.medscape.com]

  New onset ascites or ascites of unknown origin 2. [web.archive.org]

  Dimov, M.D., Clinical Assistant Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio Indications New onset ascites or ascites of unknown origin Patient with a known ascites who has fever [note3.blogspot.com]

  Endoscopic evaluation by ultrasound of low volume ascites and sampling of the ascitic fluid by endoscopic ultrasound guided paracentesis (EUS-P) is both a sensitive and specific modality for the determination of peritoneal implants, which is not only [ncbi.nlm.nih.gov]

• Inflammation

  A 34-year-old man with a three-month history of intraocular inflammation after ocular trauma with a fir branch, had an acute unilateral fulminant iridocyclitis. The iris had a thick, gray, cheesy membrane composed of nodular lepromata. [ncbi.nlm.nih.gov]

  RESULTS FROM PARACENTESIS TEST Normal: A normal test returns no signs of infection, cancer, or inflammation Abnormal: Abnormal results could mean the following: An elevated number of white blood cells in the fluid could mean infection or inflammation [barnesjewish.org]

  Other inflammations Peritoneal fluid is not just produced by infections. The pancreas can cause a massive sterile peritonitis when it leaks its digestive enzymes into the abdomen. [medical-dictionary.thefreedictionary.com]

  Your blood pressure and vital signs will be monitored periodically, and the puncture site will be observed for signs of bleeding or inflammation, usually for a few hours. [healthcommunities.com]

• Pathologist

  Exam Results Specimens are sent to an independent Pathologist for evaluation Your physician will receive a separate written report from the radiologist and pathologist within two to seven days. [advimaging.com]

  A histologic technician prepares and stains slides for cytological review by a pathologist. [encyclopedia.com]

• Anemia

  Reverse the reversible (giving FFP and Vitamin K for elevated INR), replace the replaceable (giving PRBCs and IV fluid for significant anemia and hypotension). [imrespdx.com]

• Infertility

  Here we report a 36-year-old woman with primary infertility due to endometriosis who underwent controlled ovarian hyperstimulation. [ncbi.nlm.nih.gov]

• Aspiration

  Take a clean green needle and 20ml syringe and insert through the skin advancing and aspirating until fluid is withdrawn Aspirate 20ml Remove needle and apply sterile dressing NEJM video on paracentesis Samples in paracentesis Microbiology Microscopy, [oxfordmedicaleducation.com]

  Definition (SCTSPA) Punción de un espacio con aspiración de su contenido Definition (SNOMEDCT_US) A puncture into a space with an aspiration of that space Definition (NCI_NCI-GLOSS) A procedure in which a thin needle or tube is put into the abdomen to [fpnotebook.com]

  Fluid is gently aspirated and sent for cell count, protein or amylase content, cytology, or culture as needed. [merckmanuals.com]

  [G. parakentēsis, a tapping for dropsy, fr. para, beside, + kentēsis, puncture] paracentesis /para·cen·te·sis/ ( -sen-te´sis ) surgical puncture of a cavity for the aspiration of fluid.paracentet´ic paracentesis [per′əsentē′sis] Etymology: Gk, para + [medical-dictionary.thefreedictionary.com]

• Abdominal Mass

  The patient subsequently developed an abdominal mass and ascites. [ncbi.nlm.nih.gov]

  Absolute contraindications to paracentesis include Severe, uncorrectable disorders of blood coagulation An infected abdominal wall Poor patient cooperation, surgical scarring over the puncture area, large intra-abdominal masses, and severe portal hypertension [merckmanuals.com]

• Vomiting

  Other symptoms often include: Shortness of breath Nausea Swelling in legs and ankles Indigestion Vomiting Heartburn Loss of appetite Fever Hernia If you have a combination of these symptoms, see your doctor. [webmd.com]

  Vomiting or diarrhea. Any seepage of fluid from the puncture site. You will receive a follow up phone call the day following your procedure from the nurse at Advanced Imaging. [advimaging.com]

  You have nausea or vomiting. You have sudden or very bad pain in your abdomen. You have sudden trouble breathing. Risks During abdominal paracentesis, the needle may damage your abdominal organs or blood vessels. [drugs.com]

  […] mortality has been reduced to approximately 20% with early diagnosis and prompt treatment. 85 7.1 Diagnosis Patients with SBP are frequently asymptomatic. 129, 130 However, a significant proportion have some symptoms such as fever, mild abdominal pain, vomiting [doi.org]

• Nausea

  Other symptoms often include: Shortness of breath Nausea Swelling in legs and ankles Indigestion Vomiting Heartburn Loss of appetite Fever Hernia If you have a combination of these symptoms, see your doctor. [webmd.com]

  Although small collections of fluid may by asymptomatic, larger amounts may cause abdominal pain, nausea, anorexia and infection. [acep.org]

  You have nausea or vomiting. You have sudden or very bad pain in your abdomen. You have sudden trouble breathing. Risks During abdominal paracentesis, the needle may damage your abdominal organs or blood vessels. [drugs.com]

• Diarrhea

  The incidences of gastrointestinal adverse events in the two groups were similar (p > .05), except for diarrhea. [ncbi.nlm.nih.gov]

  Vomiting or diarrhea. Any seepage of fluid from the puncture site. You will receive a follow up phone call the day following your procedure from the nurse at Advanced Imaging. [advimaging.com]

• Hypertension

  The utility of different imaging techniques in detecting such anomalies in the portal hypertensive patient with portal hypertension and ascites is discussed. The approach and management of this complication are outlined. [ncbi.nlm.nih.gov]

  The fluid that builds up in the abdomen, called ascites, is a result of a complication of cirrhosis, called portal hypertension. [texasliver.com]

• Irritability

  Patients with ascites of known etiology who may have a decompensation clinical state as indicated by fever, painful abdominal distention, peritoneal irritation, hypotension, encephalopathy or sepsis 3. Suspected malignant ascites 4. [web.archive.org]

  The tip of the locking and biliary drainage catheters are located on the inside of the pigtail curve to prevent irritation of the surrounding tissue. [merit.com]

  Floaters and Flashes Fluid Responsiveness in Unstable Patients Generalized Anxiety or Panic Disorder Glaucoma Goiter Head Trauma Health Literacy Hearing Impairment Heart Failure Hepatomegaly Hypertension Hypovolemia, Adult Hypovolemia, Child Influenza Irritable [jamaevidence.mhmedical.com]

• Stroke

  Severe Alcohol Withdrawal Syndrome Sexual Abuse, Child Shoulder Instability Sinusitis Sleep Apnea Splenomegaly Streptococcal Pharyngitis Stroke Stroke, Hemorrhagic Temporal Arteritis Thoracic Aortic Dissection Upper Gastrointestinal Bleed Urinary Incontinence [jamaevidence.mhmedical.com]

  If you take medication to thin your blood, such as to treat blood clots or to prevent a heart attack or stroke, ask the doctor who prescribes it for you when to stop taking it. [mskcc.org]

However, given the ability of EUS-P to adequately sample even minimal ascites, detecting much smaller volumes than traditional computed tomography or magnetic resonance imaging, EUS-P may be a useful modality for the standard metastatic workup of any [ncbi.nlm.nih.gov]

• Pneumoperitoneum

  Perforation of bladder and stomach (emptied prior to the procedure to decrease the risk) Bowel perforation Laceration of a major blood vessel Loss of catheter or guide wire in the peritoneal cavity Abdominal wall hematomas Pneumoperitoneum Bleeding Perforation [5minuteconsult.com]

• Hemorrhagic Ascites

  Garcia-Tsao G (2001) Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis. Gastroenterology 120:726–748 PubMed CrossRef Google Scholar 3. [link.springer.com]

  Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis. Gastroenterology 2001 ; 120 : 726 –48. ↵ Quintero E, Gines P, Arroyo V, et al. [doi.org]

Pain score at 1 and 2 hours after treatment was significantly lower in group 1 than in group 2; however, no difference was noted at 24 hours after treatment. [ncbi.nlm.nih.gov]

We seek to draw attention to this important procedure that could improve the diagnosis and prognosis of infectious uveitis. [ncbi.nlm.nih.gov]

Key Points 1 Paracentesis is used to treat peritoneal effusion, or fluid buildup. 2 Paracentesis is a treatment used for patients with peritoneal mesothelioma. 3 As a palliative treatment, paracentesis improves symptoms, but not prognosis. 4 There are [maacenter.org]

Incidence, clinical course, predictive factors and prognosis. Hepatology 1994 ; 27 : 1227 –32. ↵ Sort P, Navasa M, Arroyo V, et al. [doi.org]

Prognosis of potential candidates for orthotopic liver transplantation. J Gastroenterol Hepatol 10:47–50 PubMed Google Scholar 13. Akriviadis EA, Runyon BA (1990) Utility of an algorithm in differentiating spontaneous from secondary peritonitis. [link.springer.com]

Removal of abdominal fluid is of value in evaluating patients with ascites of new onset or unknown etiology, and provides symptomatic relief in patients with known disease or in the setting of a decompensating clinical state. [web.archive.org]

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. [nejm.org]

Performing a paracentesis will help determine the etiology of a patient's ascites. [ncbi.nlm.nih.gov]

A multicenter, case-controlled study of the clinical presentation and etiology of ascites and of the safety and clinical efficacy of diagnostic abdominal paracentesis in HIV seropositive patients. Am J Gastroenterol. 1994;89:2172–2177. [5minuteconsult.com]

Malcangi V, Cohen J, Japiassu A, De Keulenaer BL, Daelemans R, Jacquet L, Laterre PF, Frank G, de Souza P, Cesana B, Gattinoni L: Incidence and prognosis of intraabdominal hypertension in a mixed population of critically ill patients: a multiple-center epidemiological [bmcgastroenterol.biomedcentral.com]

Epidemiology of severe hospital-acquired infections in patients with liver cirrhosis: effect of long-term administration of norfloxacin. Clin Infect Dis 1998 ; 26 : 1066 –70. [doi.org]

This review summarizes current knowledge about the pathophysiology of ascites and explains the appropriate approach to clinical evaluation. [doi.org]

Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 93. Updated by: Michael M. [medlineplus.gov]

“Coagulation Disorders and Hemostasis in Liver Disease: Pathophysiology and critical assessment of current management.” Mannucci,P. “Abnormal Hemostasis Tests and Bleeding in chronic Liver Disease : Are they related? No.” [lasvegasemr.com]

Various vasoconstrictors have also been used to prevent PICD, but there are few studies about the usage of midodrine. [ncbi.nlm.nih.gov]

At this point, advance the device 2-5 mm into the peritoneal cavity to prevent misplacement during catheter advancement. [emedicine.medscape.com]

Have patient remain supine for 2-4 hours Complication Prevention Management Fluid does not flow with opening of clamp Check position of insertion and depth of insertion by U/S, or clinical exam Adjust depth of insertion or choose another site as fluid [web.archive.org]