Abstract
The classic site for paracentesis in generalized ascites is in the left lower quadrant of the abdomen at a position equivalent to McBurney's point. Its use has an average success rate of 58%, depending on the amount of liquid. To assess the efficacy of paracentesis at this site and to establish the ideal site for blind puncture, we studied 27 consecutive patients with ascites detected by abdominal ultrasonography. The amount of ascites was graded from 1 to 4. Free fluid had accumulated mostly in the perihepatic region, then around the bladder and in the right paracolic gutter, and finally in the left flank. In six of the eight patients in whom fluid was found in the left or right flank, air-filled bowel loops were observed between the abdominal wall and the fluid, in the expected path of a blind puncture. These findings suggest that the safety and efficacy of paracentesis would be greatly improved by ultrasonographic guidance.
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Selected References
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- Cattau E. L., Jr, Benjamin S. B., Knuff T. E., Castell D. O. The accuracy of the physical examination in the diagnosis of suspected ascites. JAMA. 1982 Feb 26;247(8):1164–1166. [PubMed] [Google Scholar]
- DRAPANAS T., McDONALD J. Peritoneal tap in abdominal trauma. Surgery. 1961 Nov;50:742–746. [PubMed] [Google Scholar]
- Dinkel E., Lehnart R., Tröger J., Peters H., Dittrich M. Sonographic evidence of intraperitoneal fluid. An experimental study and its clinical implications. Pediatr Radiol. 1984;14(5):299–303. doi: 10.1007/BF01601880. [DOI] [PubMed] [Google Scholar]
- Forsby J., Henriksson L. Detectability of intraperitoneal fluid by ultrasonography. An experimental investigation. Acta Radiol Diagn (Stockh) 1984;25(5):375–378. doi: 10.1177/028418518402500505. [DOI] [PubMed] [Google Scholar]
- GIACOBINE J. W., SILER V. E. Evaluation of diagnostic abdominal paracentesis with experimental and clinical studies. Surg Gynecol Obstet. 1960 Jun;110:676–686. [PubMed] [Google Scholar]
- Hashimoto B. E., Filly R. A., Callen P. W. Sonographic detection of fetal intraperitoneal fluid. J Ultrasound Med. 1986 Apr;5(4):203–204. doi: 10.7863/jum.1986.5.4.203. [DOI] [PubMed] [Google Scholar]
- King R. W. Abdominal paracentesis. Aust Fam Physician. 1983 Feb;12(2):120–120. [PubMed] [Google Scholar]
- Neuhof H., Cohen I. ABDOMINAL PUNCTURE IN THE DIAGNOSIS OF ACUTE INTRAPERITONEAL DISEASE. Ann Surg. 1926 Apr;83(4):454–462. doi: 10.1097/00000658-192604000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Proto A. V., Lane E. J., Marangola J. P. A new concept of ascitic fluid distribution. AJR Am J Roentgenol. 1976 May;126(5):974–980. doi: 10.2214/ajr.126.5.974. [DOI] [PubMed] [Google Scholar]
- Yeh H. C., Wolf B. S. Ultrasonography in ascites. Radiology. 1977 Sep;124(3):783–790. doi: 10.1148/124.3.783. [DOI] [PubMed] [Google Scholar]