Paracentesis (Abdominal Drain)

The day of your appointment

It is advisable to wear something loose around your abdomen, for example jogging bottoms or a loose fitting skirt or you can bring a change of clothing with you.

It is advisable that a responsible adult brings you to your appointment and is available to take you home afterwards. On the day of your appointment do not take your diuretics for example spironolactone or furosemide.

You will be asked to report to the Medical Day Unit .The receptionist at the Medical Day Unit will book you in and the nurse will ask some questions about your health and medications. Please ensure you bring with you a list of your medication – including any over the counter medication.

You will be advised of the benefits and risks involved in the procedure and asked to sign a consent form. 

What happens during the procedure?

A small plastic tube called a cannula (a fine tube) will be placed into a vein, usually in the back of your hand or arm using a fine needle, as in some cases we may need to give you an intra venous solution, however this depends on your liver disease.

At the start of your procedure you will be required to lie on a bed. The Doctor or Nurse will examine you to decide the best position to insert the drain into your abdomen. In some cases the Doctor or Nurse may need to use an ultrasound scan in order to locate the fluid.

Once it has been decided the best place for the drain, we will thoroughly clean the site before giving a small injection of a local anaesthetic to numb the area before inserting the drain.

A tube will be inserted to act as a drain. This is securely attached to your skin with an adhesive dressing; it will then be attached to a bag to collect the fluid coming from your abdomen. The bag is then attached to a catheter stand; this allows us to empty it at regular intervals.

A small amount of the fluid may be sent to the lab for analysis, this is to look for signs of infection, and the results of this will be available that day.

Once the drain is in place you will be asked to sit in a chair to assist the removal of fluid from around the abdomen. The drain will stay in place for a maximum of six hours before it is removed to minimise the risk of infection.

You will be asked to remain in the chair throughout the day although you will be able to use the toilet facilities as normal. At regular intervals the Nurse will monitor your blood pressure, pulse, temperature and record the amount of fluid removed.

What happens after the procedure?

After six hours, or if there is no further fluid, you will be asked to lie on the bed so the drain can be removed by the Nurse. This is simple and painless. Once the drain is removed a waterproof dressing will be placed over the area and should remain in place for 24 hours and kept as dry as possible.

The cannula will be removed and a dressing applied. Once the Nurse is satisfied that you have no bleeding from the drain site and your temperature, pulse and blood pressure are stable you will be discharged home, this is usually after 6-8 hours from your arrival.

What are the risks?

As with any procedure there are risks, complications and side effects. Paracentesis is a safe procedure with a very small rate of significant complications (less than 1 in 1000 people). ¹

Common after the procedure the patient can experience:

• Lethargy – it is common to feel tired after the procedure
• Pain – some patients experience increased discomfort in the tummy
• Leakage – this can occur up to 72 hours after the procedure.

Rare Complications:

• Infection at the drain site and/or in the abdominalcavity
• Bleeding
• Circulatory problems such as low blood pressure.
• Injury/damage to the internal organs

Do you stay in hospital overnight?

For most patients the procedure is carried out as a day case, however rarely you may need to be admitted to the ward. Once the drain is removed and you are feeling well you should be able to return home.

What to do once you get home?

Should you have any immediate concerns once you return home you can contact Liver Specialist nurse or in an emergency see contact details below.

You should continue to weigh yourself daily and measure around your abdomen weekly, keeping a record of this will help plan for any future appointments you may need.

Contact Numbers

For further advice or information please contact:

Liver Specialist Nurse

Tel: 01642 617617 or Ext. 24715

Medical Day Unit

Tel: 02642 617617 or Ext. 83926

Monday to Friday – 8:30 a.m. to 4:30 p.m.

Out of Hours – contact your GP

NHS Choices

Telephone: 111 ( when it is less urgent than 999)

Calls to this number are free from landlines and mobile phones or via the website at www.nhs.uk

References

• Aithel GP et al (2020) Guidelines on the Management of Ascites in Cirrhosis GUT 0.1-21. BMJ Journals. London.

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information, please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]