A Safe Procedure

\s=b\A prospective study of 229 abdominal paracenteses performed on 125 patients with ascites revealed only two major complications (transfusion-requiring abdominal wall hematomas) in a single patient (0.9% of paracenteses and 0.8% of patients), and two minor complications (non-transfusion-requiring hematomas) in two patients (0.9% of paracenteses and 1.6% of patients). No paracentesis resulted in bacterial peritonitis or death. Abdominal paracentesis in patients with ascites is a safe procedure. Fear of complications of the procedure should not preclude performing a paracentesis, provided certain precautions are taken. (Arch Intern Med 1986;146:2259-2261) "physicians occasionally are reluctant to perform a paracentesis of ascitic fluid because of fear of complications. This fear of complications may be based on the literature of the subject, which is retrospective, which emphasizes complications, and some of which is from an era when largecaliber needles were used.17 Conn6 hypothesized that para¬ centesis might cause ascitic fluid infection by inoculating bacteria-laden blood into the fluid during the procedure and/or by perforating the bowel with the paracentesis needle. Concern about complications from paracentesis has led some authors actually to recommend a "minilaparotomy" as a safer method to sample ascitic fluid.8 My experi¬ ence, that abdominal paracentesis rarely results in compli¬ cations, prompted a prospective study to determine the morbidity and mortality of this procedure.