What are the complications of abdominal paracentesis?
Nov 05, 2025
Source: Cainiu Health
Dr. Wang Lei
Introduction
In general, paracentesis, a common procedure for the diagnosis and treatment of intra-abdominal diseases, may lead to complications including bleeding, infection, organ injury, intra-abdominal adhesions, and failed puncture. When performing paracentesis, strict adherence to aseptic techniques is required, along with thorough preoperative assessment of the patient's coagulation function and the status of intra-abdominal fluid accumulation.
Generally, abdominal paracentesis, a common procedure for diagnosing and treating intra-abdominal diseases, may lead to complications including bleeding, infection, organ injury, intra-abdominal adhesions, and failed puncture. A detailed analysis is as follows:
1. Bleeding: This usually results from injury to abdominal wall or intra-abdominal blood vessels by the needle, commonly occurring in patients with coagulation disorders or inaccurate needle placement during the procedure. Manifestations include oozing at the puncture site or subcutaneous hematoma; severe cases may involve intra-abdominal hemorrhage, presenting with abdominal pain and pallor.
2. Infection: This primarily arises from inadequate aseptic technique during the procedure, allowing bacteria to enter the abdominal cavity or puncture site. Local infection presents with redness, swelling, pain, and fever at the puncture site, while intra-abdominal infection may trigger peritonitis, characterized by worsening abdominal pain and abdominal muscle rigidity.
3. Organ injury: This often occurs due to improper control of puncture depth or abnormal anatomical position of intra-abdominal organs. Commonly injured organs include the intestines, bladder, and liver. Bowel injury may cause perforation, leading to severe abdominal pain, nausea, and vomiting.
4. Intra-abdominal adhesions: Repeated paracentesis may irritate the peritoneum, promoting fibrous tissue proliferation and resulting in adhesions between the intestinal tract and abdominal wall or between loops of bowel. Mild adhesions may be asymptomatic, but severe cases can lead to adhesive intestinal obstruction, manifesting as abdominal pain and cessation of flatus and defecation.
5. Failed puncture: This typically results from insufficient ascites volume, improper puncture site selection, or poor patient positioning and cooperation. It is characterized by inability to aspirate fluid or withdrawal of only small amounts of blood or gas.
During abdominal paracentesis, strict adherence to aseptic techniques is essential. Pre-procedural assessment should include evaluation of the patient's coagulation status and amount of ascites. Accurate localization and careful control of puncture depth are critical during the procedure. Post-procedural monitoring of vital signs and abdominal symptoms is necessary, with prompt management of any abnormalities to minimize complication risks and ensure procedural safety.
