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What are the three locations for abdominal paracentesis?

May 17, 2023 Source: Cainiu Health
Dr. Li Feng
Introduction
The three puncture sites for abdominal paracentesis are paramedian puncture, left lower quadrant puncture, and lateral decubitus puncture. Specifically, abdominal paracentesis involves inserting a needle through the abdominal wall to withdraw accumulated fluid, which is then examined to aid in diagnosing related diseases, primarily used in individuals with closed abdominal injuries. After the procedure, a small wound remains on the skin surface; therefore, enhanced skin protection is necessary.

Generally, there are three common sites for abdominal paracentesis: paramedian puncture, left lower quadrant puncture, and lateral decubitus puncture. The details are as follows:

1. Paramedian Puncture

Abdominal paracentesis involves inserting a needle through the abdominal wall to withdraw accumulated fluid for examination, aiding in the diagnosis of related diseases, especially in patients with closed abdominal trauma. The paramedian site is located slightly to the left or right of the midline above the line connecting the umbilicus and pubic symphysis. This area lacks major organs and is therefore relatively safe.

2. Left Lower Quadrant Puncture

The left lower quadrant puncture site is at the intersection of the line connecting the pubic symphysis and the left iliac region. This location helps avoid abdominal arteries and intestines, reducing the risk of bowel perforation or severe bleeding.

3. Lateral Decubitus Puncture

This site lies between the umbilicus and the anterior axillary line. It is commonly used for diagnostic paracentesis, particularly suitable for patients with small amounts of abdominal fluid.

After the procedure, a small wound remains on the skin surface. Therefore, proper skin care is essential—avoid getting the area wet too soon, minimize friction, and prevent wound infection.


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