Unifying Concepts

Indications and Contraindications for Abdominal Paracentesis

Removal of abdominal fluid is of value in evaluating patients with ascites of new onset or unknown etiology, and provides symptomatic relief in patients with known disease or in the setting of a decompensating clinical state. Abdominal paracentesis is a simple procedure that may be performed rapidly and with a minimum of equipment.


  • New onset ascites or ascites of unknown origin
  • Patients with ascites of known etiology who may have a decompensation clinical state as indicated by fever, painful abdominal distention, peritoneal irritation, hypotension, encephalopathy or sepsis
  • Suspected malignant ascites
  • Peritoneal dialysis patients with fever, abdominal pain or other signs of sepsis (usually the paracentesis fluid may be removed directly from the patient’s dialysis catheter)


  • Uncorrected bleeding diathesis
  • Previous abdominal surgeries with suspected adhesions
  • Severe bowel distention
  • Abdominal wall cellulitis at the proposed site of puncture



  1. Runyon BA. Paracentesis of ascitic fluid. A safe procedure. Arch Intern Med. 1986 Nov;146(11):2259-61. [Medline]


Created: May 22, 2009

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