Ultrasound for Detection of Ascites and for Guidance of the Paracentesis Procedure: Technique and Review of the Literature

Josh Ennis^1*, Geoffrey Schultz², Phillips Perera¹, Sarah Williams¹, Laleh Gharahbaghian¹, Diku Mandavia³

¹Division of Emergency Medicine, Stanford University Medical Center, Stanford, USA.
²Emergency Professional Services, Phoenix, USA.
³Department of Emergency Medicine, LAC+USC Medical Center, Los Angeles, USA.

DOI: 10.4236/ijcm.2014.520163                

Abstract

Objective: To review the use of ultrasound (US) for the detection of free intraperitoneal fluid (ascites) and for the procedural guidance of the paracentesis procedure. Methods: Two clinical vignettes are presented to review the pertinent diagnostic, management and safety considerations associated with paracentesis. First, US techniques used for the identification of ascites and in the quantification of fluid pockets amenable to aspiration will be discussed. Next, the actual steps required for the performance of US-guided paracentesis will be covered. A review and analysis of the most current literature regarding US and paracentesis then follows. Conclusion: Current literature favors US-guided paracentesis over the traditional blind technique with a significant reduction in both the rate of unsuccessful aspiration of fluid and in the bleeding complications related to this procedure. Use of US for both the diagnostic and therapeutic management of ascites should be advocated as an essential skill for physicians and other health care providers caring for these patients.

Keywords

Ultrasound for Detection of Ascites and for Guidance of the Paracentesis Procedure: Technique and Review of the Literature

Conflicts of Interest

The authors declare no conflicts of interest.

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