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Learn About Conditions and Procedures

What is Trauma?

Trauma is a serious injury or shock to the body. It is caused by a physical force such as violence or an accident. The injury may be complicated by psychiatric, behavioral, and social factors.

It is critical to have an entire team immediately available to provide care to an injured patient 24-hours a day. This teamwork starts at the scene of the injury where a coordinated, statewide pre-hospital medical system rapidly transports the injured patient from the scene to the hospital providing the appropriate level of care according to criteria established in the statewide trauma regulations. Once at the hospital, a complete team of surgeons, emergency physicians and nurses continue the life-saving treatment.

This team approach to care of the injured patient has had a dramatic impact on saving lives.

Minimally Invasive Procedures for Massive Bleeding

Injuries take many forms. The most advanced hospitals can treat injuries with a variety of approaches that involve well-known ones, like surgery, and newer ones where minimally invasive procedures can replace some surgeries.

As a Level 1 Trauma Center, Hartford Hospital has Interventional Radiologists as part of the Trauma Team. They perform procedures such as "embolization" which is a recognized interventional radiology technique that is used to treat trauma patients with massive bleeding.

Click here to see some of the advanced interventional techniques available at Hartford Hospital.

Learn more about trauma, or search below to learn about other health conditions.

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Abdominal Paracentesis

(Ascites Fluid Tap; Abdominal Tap)

by Editorial Staff And Contributors

En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

Usually, there is very little fluid in the abdominal cavity. However, there are a number of conditions that can cause fluid to build up in the abdomen. This is called ascites. When fluid builds up, an abdominal paracentesis may be done. With this procedure, a needle is used to remove a sample of fluid or to drain fluid that has built up.

Ascites

Reasons for Procedure

This is done to find out why there is fluid build-up in the abdomen. Causes may include:

Bleeding
Infection
Diseases of organs, such as the liver
Cancer

This procedure may also be done when fluid in the abdomen:

Makes breathing difficult
Causes pain

Abdominal fluid can return until the condition causing it has been treated. You may need to have the procedure again.

Possible Complications

Complications are rare. But no procedure is completely free of risk. If you are planning to have an abdominal paracentesis, your doctor will review a list of possible complications, which may include:

Bleeding
Infection
Accidental piercing of structures in the abdomen

Some factors that may increase the risk of complications include:

Smoking
Bleeding disorder
Poor nutrition
Pregnancy
Full bladder
Infection in the area where the paracentesis instrument will be inserted

Be sure to discuss these risks with your doctor before the procedure.

What to Expect

Your doctor may do some or all of the following:

Physical exam
Blood tests
X-ray
CT scan
Ultrasound
MRI scan

If the procedure is scheduled (rather than done in an emergency):

Do not eat or drink for 12 hours before the procedure.
Empty your bladder just before the procedure.

You will receive local anesthesia. The area will become numb. You will stay awake during the procedure.

This is usually done in the doctor's office. In some cases, your doctor may have you go to the hospital before or after this procedure. If you are already in the hospital for a different reason, this procedure will not extend your stay.

In most cases, you will lie on your back. In some instances, you may need to be in a different position. The area where the needle will be inserted is cleaned with a solution and draped with sterile cloths. An injection of a local anesthetic will be given to numb the area. The doctor will carefully insert the needle into the abdomen. The fluid will be removed using a syringe.

The amount of fluid removed depends on your condition. If it is being done to make a diagnosis, the doctor will remove a small amount of fluid. If the procedure is being done to make you feel better, more fluid may be removed.

About 10-15 minutes (depending on how much fluid needs to be removed)

There will be some stinging or burning while the anesthesia is injected. After the area is numb, you will not feel pain.

You will stay in the recovery room for a few hours. Your blood pressure and other vital signs will be monitored. If you have a lot of fluid leakage or are having trouble breathing, you may need to stay in the care center.

Rest the day after your procedure.
Follow your doctor's instructions .

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or fluid from the paracentesis site
Pain that you cannot control with the medicines you have been given
Cough, shortness of breath, feeling faint, or chest pain
Swelling of the abdomen

In case of an emergency, call for medical help right away.

American Cancer Society

http://www.cancer.org/

American Academy of Family Physicians

http://familydoctor.org/

Canadian Cancer Society

http://www.cancer.ca/

Health Canada

http://www.hc-sc.gc.ca

Ascites. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 8, 2012. Accessed January 2, 2013.

Aslam N, Marino CR. Malignant ascites: new concepts in pathophysiology, diagnosis, and management. Arch Intern Med. 2001;161:2733-2737.

Covey AM. Management of malignant pleural effusions and ascites. The Journal of Supportive Oncology. 2005;3:169-173.

Smith EM, Jayson GC. The current and future management of malignant ascites. Clin Oncol. 2003;15:59-72.

6/2/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

Last reviewed November 2012 by Marcin Chwistek, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.