Therapeutic Paracentesis (Abdominal drain)

Acute Medicine

Patient Information Leaflet

This leaflet provides information about the abdominal drain procedure, including its benefits, potential risks, and what to expect during your hospital visit. If you have any additional questions, please speak with the doctor or nurse looking after you.

Therapeutic Paracentesis

Therapeutic paracentesis or large volume paracentesis (LVP) is a procedure to remove fluid that has accumulated in the abdominal cavity, this fluid is called ascites. Ascites is most commonly caused by cirrhosis of the liver, but there are other rarer causes including cancer

Therapeutic paracentesis involves removing the ascites using a needle and catheter which is inserted through the abdominal wall. Fluid is often sent to a lab for analysis to determine the cause (if not already known) and to screen for infection.  Paracentesis is usually done to drain the fluid as a comfort and safety measure.

Why It Is Done

Therapeutic paracentesis may be done to:

• Determine the cause of fluid build-up in the abdominal cavity (ascites) at the same time as removing the fluid.
• Diagnose infection in the peritoneal fluid.
• Detect certain types of cancer, such as liver cancer.

Remove a large amount of fluid that is causing pain or difficulty breathing or that is affecting the function of the kidneys or the intestines (bowel).

Risks

• The abdominal drain procedure is generally safe, but like any medical procedure, there are some manageable risks:
• Bleeding: This is the most common risk. To keep you safe, we check your blood beforehand to ensure your clotting levels are within a safe range. If needed, we can provide medication or blood products to correct clotting issues before proceeding.
• Damage to organs: There is a very small chance of accidentally puncturing an organ inside the abdomen. We reduce this risk by reviewing your recent scans or using an ultrasound to guide the procedure.
• Infection: Although rare, there is a small risk of introducing infection. To prevent this, we always perform the procedure under sterile conditions, and the drain is removed either after six hours or once the fluid stops draining—whichever happens first.
• Leakage: Occasionally, a small amount of fluid may leak from the drain site after the procedure. This is usually temporary and can be managed with dressings and/ or a temporary stoma bag. However, if the leakage persists, a small suture (stitch) may be applied to close the site.
• Low blood pressure or kidney effects: Removing fluid from the abdomen can sometimes lower blood pressure or affect the kidneys. To reduce this risk, we may give you a concentrated protein solution at intervals during the procedure.

Procedure

Before the procedure:

It is advisable to skip your water tablet (e.g. spironolactone or furosemide) on the day of procedure, if you are taking these medications.

Normally you will have been booked in as an elective patient which means that you will come in as a day case. You can eat and drink as usual prior to this procedure. The procedure will be performed either on ward C7, A2 day case ward or SDEC.

The professional performing the procedure will explain what happens to you and ask you to sign a consent form.

During the procedure:

Once your blood has been checked, you will lie comfortably on a couch or bed. A small injection of local anaesthetic will be given into the skin of your abdomen. This may sting slightly but will quickly numb the skin and deeper tissues down to the fluid.

Once the area is numb, a small opening is made in your skin to help insert the drain more easily. The drain will then be secured with tape and connected to a bag to collect the fluid. In some cases, we may send samples of the fluid to the laboratory for further testing.

After the procedure:

The drain will be removed once it has stopped draining, you have reached the maximum fluid limit, or the time limit of six hours has passed. Ward staff will carefully remove the drain and place a sterile gauze dressing over the site, secured with tape. In some cases, medical glue may be used to seal the site and prevent leakage.

After the procedure, you don’t need additional bed-rest unless you feel the need to. If you experience any discomfort, you can take simple pain relief, such as paracetamol. However, if the discomfort persists and you find yourself needing regular pain relief, please inform the nurse looking after you.

Do I have to stay in hospital?

Most patients come to the hospital on the morning of the procedure and can go home once the fluid has finished draining, as long as they are feeling well. The fluid is drained gradually, so you should plan to be in the hospital for at least 6 hours.

It’s a good idea to bring a change of clothing with you, just in case you need it during your visit.

Convalescence

Recovery time after your procedure can vary from person to person, but typically takes between one to two days. Once home, it is important to rest quietly for the remainder of the day.

If you have any of the following, please contact your nearest Accident and Emergency Department (not minor injuries)

• Excessive bleeding from the drain site
• Excessive sweating
• Excessive shivering
• Feeling generally unwell
• Increasing pain

If you have any questions, or if there is anything you do not understand about this leaflet, please contact Russells Hall Hospital on 01384 456111. Ask to speak to the on-call Obstetric Anaesthetist.

If you have any feedback on this patient information leaflet, please email dgft.patient.information@nhs.net

Reference: DGH/PIL/02180. Originator: Dr Dominic King, Consultant Gastroenterologist and IBD Service Lead. Date: June 2026. Next Review Date: June 2030. Version 1.