Skip to content 
Risks and complications of paracentesis
Paracentesis is a surgical procedure. As such, it is subject to risks and complications. However, compared to early literature about paracentesis, the actual incidence of complications and mortality is much lower. With current techniques, it is now a safer procedure than it was years ago.
Most studies report no infections or deaths after the procedure, and the only absolute contraindication is a severe blood clot problem such as fibrinolysis and disseminated intravascular coagulation.
Some relative contraindications include severe bowel distension, pregnancy, and previous extensive surgery in the abdominal cavity. Doctors would include ultrasound scans to make the procedure safe in such cases.
Still, we can list a few risks that include:
1) Bleeding risk
As a surgical procedure, there is always a risk of bleeding after paracentesis. Bleeding in such cases manifests as a hematoma in the abdominal wall, but in some cases, it is very severe and causes a complication known as hemoperitoneum. However, this bleeding risk is not severe and rarely requires a transfusion. To reduce the bleeding risk, special care should be taken in patients with thrombocytopenia and coagulopathies.
Patients receiving anticoagulant medications should also be evaluated before the procedure. Close monitoring may also be required in patients with renal impairments because they could have a platelet defect.
Depending on the procedure site, there’s a higher or lower bleeding risk. According to studies, midline paracentesis bleeds more commonly because patients may have intra-abdominal varices in this location.
