Ascites and its causes
The accumulation of fluid in the abdominal cavity is most often associated with cirrhosis of the liver, less often with an oncological process, heart failure, and peritoneal tuberculosis. With a significant volume, the abdomen increases, shortness of breath, heaviness and indigestion appear. Laparocentesis quickly relieves these symptoms. At the same time, the fluid is sent for analysis: determination of protein, cellular composition and atypical cells makes it possible to clarify the cause of ascites. The procedure is performed under ultrasound control, the puncture point is selected away from organs and blood vessels. A limited volume is removed at once, with massive ascites - with protein replacement to avoid a sharp drop in pressure.
Why is liquid removed?
The accumulation of fluid in the pleural or abdominal cavity has two sides. Firstly, it mechanically compresses the lung or abdominal organs, causing shortness of breath, heaviness and disruption of organ function - its evacuation brings immediate relief.
Secondly, the liquid itself is the most important diagnostic material. Its analysis determines the nature of the process: inflammation, tumor, heart failure, cirrhosis of the liver. Often it is the puncture examination that makes the final diagnosis.
Puncture or drainage
Puncture is a one-time removal of fluid with a needle. It is suitable for small volumes and for diagnostic purposes. Drainage is the installation of a tube that remains in the cavity for several days and ensures constant outflow. It is chosen for large volumes, purulent contents and rapid re-accumulation of fluid.
Safety of the procedure
The modern standard is to perform a puncture under ultrasound guidance: the doctor sees the exact location of the fluid, lung and diaphragm. This significantly reduces the risk of pneumothorax and organ damage compared to blind puncture. A limited volume is evacuated at once to avoid a sharp shift of the mediastinum and a drop in pressure.