Paracentesis is a medical procedure in which excess fluid, known as ascites, is drained from the abdominal cavity using a needle and catheter. This minimally invasive procedure can provide significant relief from pain and pressure caused by fluid accumulation, improving a patient’s quality of life. This article will discuss the indications for paracentesis, how an interventional radiologist performs image-guided paracentesis, the volume of fluid that can be removed, and the benefits of the procedure.

Indications for Paracentesis

Paracentesis is often indicated for patients experiencing the following conditions:

  1. Ascites: Fluid accumulation in the abdominal cavity, commonly resulting from liver disease (such as cirrhosis), heart failure, kidney disease, or certain cancers.
  2. Diagnosis: When the cause of ascites is unclear, paracentesis may be performed to collect a fluid sample for laboratory analysis.
  3. Therapeutic relief: In cases where ascites causes significant discomfort, pain, or difficulty breathing, paracentesis can provide relief by removing the excess fluid.

Image-Guided Paracentesis Procedure

An interventional radiologist, a specialist in minimally invasive image-guided procedures, performs paracentesis using ultrasound or fluoroscopic guidance:

  1. The patient is positioned on their back or side, and the skin is cleaned and sterilized at the insertion site.
  2. Local anesthesia is administered to numb the area and minimize discomfort during the procedure.
  3. Using ultrasound or fluoroscopic guidance, the interventional radiologist inserts a thin needle through the skin and into the abdominal cavity.
  4. A catheter is then threaded through the needle, and the needle is removed.
  5. Fluid is drained from the abdomen through the catheter, either by gravity or with the help of a vacuum container.
  6. Once the desired volume of fluid has been removed, the catheter is withdrawn, and the insertion site is covered with a sterile dressing.

Volume of Fluid Removal and Benefits

The amount of fluid removed during paracentesis varies depending on the patient’s condition and the severity of the fluid accumulation. In some cases, only a small sample is collected for diagnostic purposes, while in others, several liters of fluid may be drained to alleviate pain, pressure, and other symptoms.

The benefits of paracentesis include:

  1. Pain and pressure relief: By removing excess fluid, paracentesis can alleviate abdominal pain, pressure, and discomfort associated with ascites.
  2. Improved breathing: Fluid accumulation in the abdomen can put pressure on the diaphragm, making it difficult for patients to breathe. Paracentesis can help improve respiratory function by reducing this pressure.
  3. Diagnostic value: Analyzing the ascitic fluid can help determine the underlying cause of fluid accumulation, guiding further treatment and management.
  4. Minimally invasive: Compared to other surgical interventions, paracentesis is less invasive and has a lower risk of complications.


Paracentesis is a valuable diagnostic and therapeutic procedure for patients with fluid accumulation in the abdominal cavity. Performed by an interventional radiologist using image guidance, paracentesis can provide significant relief from pain, pressure, and difficulty breathing, improving a patient’s quality of life. If you or a loved one are experiencing symptoms of ascites, consult with a healthcare professional to determine if paracentesis is the right option for you.