Paracentesis; Risks & Complications of Paracentesis

How do you know you have ascites?

Doctors are trained to detect ascites in many ways. There is a small volume of fluid in the peritoneal cavity in healthy patients, which is around 50 milliliters. The leading cause of ascites is portal hypertension, a common complication in many liver diseases. Other causes include heart failure, cancer, kidney problem, pancreatic disease, and tuberculosis. Patients with these health problems are at a higher risk of ascites.

Doctors would evaluate additional symptoms in your body. A prevalent accompanying symptom is ankle edema, and most of these patients have an increase in abdominal girth. Doctors will also find signs in the physical exam by applying specific maneuvers. They include:

• Shifting dullness: In this maneuver, the doctor will ask you to change positions from one side to the other. In each case, he will tap gently and hear the resulting sound. The sound is dull where the water is located, and it changes as you change position.
• Flank dullness: Flank percussion would cause a dull sound because there’s a structure in this area that is always filled with water in case of ascites.
• Fluid wave: In this case, doctors will ask you to remain lying on your back and tap on one side of the abdomen. This creates a superficial liquid wave in the abdomen that sometimes reaches the other side.
• Bulging flanks: When patients lay on their back, both flanks create a visible protuberance as they are filled with liquid.

All of these signs and symptoms should be confirmed by an ultrasound scan. Sonography is considered the gold standard to detect ascites. In other words, it is the more accurate method to obtain a diagnosis.