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A correction has been published: N Engl J Med 2007;356(7):760.

Videos in Clinical Medicine
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Volume 355:e21 November 9, 2006 Number 19
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Paracentesis
Todd W. Thomsen, M.D., Robert W. Shaffer, M.D., Benjamin White, M.D., and Gary S. Setnik, M.D.

Since this article has no abstract, below are the first 100 words from the narration of this Video in Clinical Medicine and its chapter headings.

 
 

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Figure 1
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Abdominal paracentesis is performed as a diagnostic procedure to establish the etiology of new-onset ascites or to rule out spontaneous bacterial peritonitis in patients with preexisting ascites. Large-volume paracentesis is performed in hemodynamically stable patients with tense or refractory ascites to alleviate discomfort or respiratory compromise. Contraindications Many patients undergoing paracentesis will have baseline coagulopathy or thrombocytopenia. However, the incidence of clinically significant bleeding during paracentesis is extremely low, and routine use of fresh-frozen plasma or platelet concentrates is not recommended. Paracentesis should be avoided in patients with disseminated intravascular coagulation. The paracentesis needle should not pass through sites . . . .

Chapters:

  • Overview
  • Indications
  • Contraindications
  • Equipment
  • Preparation
  • Paracentesis
  • Analysis
  • Complications

 
References

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  2. Sandhu BS, Sanyal AJ. Management of ascites in cirrhosis. Clin Liver Dis 2005;9:715-732. [CrossRef][Medline]
  3. Ginès P, Cárdenas A, Arroyo V, Rodés J. Management of cirrhosis and ascites. N Engl J Med 2004;350:1646-1654. [Free Full Text]
  4. Pache I, Bilodeau M. Severe haemorrhage following abdominal paracentesis for ascites in patients with liver disease. Aliment Pharmacol Ther 2005;21:525-529. [CrossRef][Web of Science][Medline]
  5. McVay PA, Toy PTCY. Lack of increased bleeding after paracentesis and thoracentesis in patients with mild coagulation abnormalities. Transfusion 1991;31:164-171. [CrossRef][Web of Science][Medline]
  6. Marx JA. Peritoneal procedures. In: Roberts JR, Hedges J, eds. Clinical procedures in emergency medicine. 4th ed. Philadelphia: Saunders, 2004:851-6.
  7. Shaheen NJ, Grimm IS. Comparison of the Caldwell needle/cannula with Angiocath needle in large volume paracentesis. Am J Gastroenterol 1996;91:1731-1733. [Web of Science][Medline]
  8. Schlottmann K, Gelbmann C, Grune S, Lock G, Scholmerich J. A new paracentesis needle for ascites and pleural effusion compared with the venous indwelling catheter: a prosective, randomized study. Med Klin (Munich) 2001;96:321-324. [Medline]
  9. Promes SB. Paracentesis. In: Reichman EF, Simon RR. Emergency medicine procedures. New York: McGraw-Hill, 2004:467-77.
  10. Runyon B. Ascites and spontaneous bacterial peritonitis. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's gastrointestinal and liver disease. 7th ed. Philadelphia: Saunders, 2002:1517-42.
  11. Sort P, Navasa M, Arroyo V, et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med 1999;341:403-409. [Free Full Text]



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