Ascites puncture

• You do NOT need to be sober for an ascites job.
• The bladder must be empty before the start of the puncture. That is why it is recommended to go to the toilet beforehand.
• An ultrasound of your abdomen is usually done before the puncture. This is necessary to determine where your stomach is best pricked. We mark this place with a marker on your stomach.

Report the following things in advance:

• Any allergies.
• Fever in the past few days.
• Your home medication.
• Bleeding problems

Before the examination

• You may lie on your back on the bed, possibly tilting slightly to the left.
• Your belly should be bared.
• The puncture site will be disinfected.
• The skin will be anesthetized locally if ascitic fluid will be removed.
• The doctor inserts the needle.
• The ascitic fluid is withdrawn.

At a ascites puncture as part of a study the ascitic fluid is drawn directly into a syringe. Once sufficient ascitic fluid has been collected to be passed on to the laboratory, the needle is removed from the abdomen and the puncture site is covered with a bandage.
 
At a ascites puncture as treatment the ascitic fluid is collected in a tube (catheter) that connects to a type of collection system that is hung at the bottom of your bed. The catheter remains in place until the ascitic fluid no longer runs out or until the maximum allowed amount of fluid has run out that has been previously agreed with the doctor. During the expiration of the moisture, it is possible that we ask you to take a different position. When no more fluid flows out, the catheter is removed and the puncture site is covered with a bandage. Sometimes both types of ascites function are combined. Then some fluid is collected via the drainage system to be sent to the laboratory for research. Proteins In some cases (depending on the cause of the accumulation of fluid in the abdomen), ascitic fluid contains a lot of protein. By letting the fluid drain, you will in that case lose a lot of protein via the abdominal fluid. As a result, you may need an infusion to compensate for this loss of protein.

• After the ascites puncture, it is best not to make any major efforts as your body has to get used to the new situation.
• Your pulse, blood pressure, and temperature are monitored.
• It is checked whether the puncture site is not bleeding and that no more moisture is seeping out.
• If everything goes well, you can gently get back up.
• You can still go home the day, unless otherwise agreed with your doctor.
• Feel free to shower or take a bath after the puncture.

• (Mild) pain may occur after puncturing the peritoneum. Usually, this pain disappears spontaneously after a few hours. If it persists, contact your doctor.
• When ascitic fluid continues to seep out of the puncture site, we can apply a bag to collect this moisture until the outflow has stopped.
• If you take blood thinners or have a bleeding disorder, a bruise may occur at the site where you were pricked (despite prolonged stinging).
• If you get a fever (>38.5°C), it is best to contact your doctor.
• If the skin around the insertion hole becomes fiery red and the area of the incision is sore, you should also contact your doctor.

An ascites puncture is often a safe procedure that involves little or no risks. Rarely, bleeding can still occur.