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Case Reports
. 2023 Nov 27;8(2):136-141.
doi: 10.24908/pocus.v8i2.16265. eCollection 2023.

Troubleshooting Paracentesis Using POCUS

Angelina Voronina  1   2 , Nachelle Aurelien  1 , Edward Bergin  1   3 , Paula Roy-Burman  1
Affiliations
Case Reports

Troubleshooting Paracentesis Using POCUS

Angelina Voronina et al. POCUS J. .

Abstract

Paracentesis is a procedure routinely performed at the bedside in the evaluation and management of ascites. While point of care ultrasound (POCUS) assistance during paracentesis is known to reduce the risk of procedure-related complications, intraprocedural POCUS to overcome commonly occurring issues, such as obstructed flow through the centesis catheter, remain poorly described. In this report, we present two cases in which bowel adhered to the catheter during paracentesis. POCUS was used in an attempt to restore flow. Based on our literature review and procedural experience, we propose an algorithm to surmount this routinely encountered problem.

Keywords: Ascites; Complications; Paracentesis; Procedures.

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Conflict of interest statement

The authors report no relevant disclosures related to this work.

Figures

Figure 1
Figure 1. 23-year-old man with metastatic cancer of unknown origin complicated by ascites. A) Pre-procedure POCUS exam demonstrating a large pocket of ascites in the right lower quadrant of the patient described in Case 1. [Asterisk = liver] B) Intraprocedural POCUS demonstrating paracentesis catheter attached to omentum/bowel. Note that the ultrasound probe was inadvertently flipped in this image. [Arrow = catheter; asterisk = liver]
Figure 2
Figure 2. 68-year-old woman with decompensated alcoholic cirrhosis. A) Pre-procedural POCUS exam demonstrating large volume ascites in the left lower quadrant of the patient described in Case 2. B) Intraprocedural POCUS exam demonstrating attachment of omentum/bowel to the paracentesis catheter. [Arrow = catheter]
Figure 3
Figure 3. Proposed paracentesis troubleshooting algorithm. Systematic approach to identifying the etiology of obstructed peritoneal drainage and improve catheter flow during paracentesis.
See this image and copyright information in PMC

References

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