Diagnosis

Puncture water in the abdomen

introduction

Some illnesses, including serious illnesses, can lead to an abnormally high amount of water in the abdomen, which causes further discomfort. In order to improve the problem and to obtain diagnostic information about the cause, the water in the abdomen is punctured and drained. The puncture is then examined in the laboratory for certain ingredients and bacteria.

Often there is a recurrence of water in the abdomen and a new puncture. The most common causes of a puncture of water in the abdomen are ascites, the so-called ascites, the drainage of an abscess or an inflammation of the peritoneum.

Read more on the subject at: Water in the stomach

Reasons to puncture water in the abdomen

Broadly speaking, there are two reasons for puncturing water in the abdomen. On the one hand, it can be used as a diagnostic measure. This allows conclusions to be drawn about possible causal diseases after a subsequent analysis of the water obtained. On the other hand, punctures of the water in the abdomen can take place as part of a therapy.

Diagnostic punctures of the water in the abdomen are carried out if it is unclear why this happened. Any new case of water in the abdomen should also be punctured to rule out other causes. Furthermore, when the liver is remodeled by connective tissue, known as cirrhosis of the liver, water can accumulate in the abdomen. If the patient's condition or liver values deteriorate rapidly, this can be an indication of peritonitis. Here a diagnostic puncture of the water in the abdomen should be carried out in order to rule out peritonitis.

Therapeutic punctures of the water in the abdomen provide relief. If too much water has accumulated in the stomach, this can lead to serious impairments. After reducing the water, organs and surrounding tissues are spared and mobility is restored. In the case of an abscess, cirrhosis of the liver, or peritonitis, a therapeutic puncture can be performed to remove the focus of the disease. Acute liver damage, a tumor or the occlusion of liver vessels or lymph vessels as well as other inflammations in the abdomen can be the cause of water in the abdomen. Heart failure can also be the cause.

Prepare for the puncture

The basis for a medical intervention is always the conversation. This should clarify the patient's complaints and individual requirements. The coagulation parameters should always be determined. A physical examination should also be carried out and the hair removed if necessary. Since a puncture of water in the abdomen is also an invasive procedure, an explanation must always be given in order to clarify possible risks beforehand. Depending on whether the puncture is performed in the hospital or not and the complaints require prompt intervention, the puncture is either promptly punctured or another appointment is made. It is advisable to empty the urinary bladder immediately before the procedure.

procedure

As soon as all preparations have been completed, the puncture can continue. To do this, the patient usually lies on his back on a couch. In order not to injure any deeper-lying, important organs, the doctor now looks for a place on the abdomen where there is no danger. Usually this is done with the help of an ultrasound device. If such a point is found, it is marked.

General anesthesia is not necessary. However, the skin and deeper layers are numbed with the help of local anesthetics. This means that no pain is felt during the procedure. Since infections are a high risk, the area around the puncture site is generously disinfected. An indwelling venous cannula can now be used to pierce the abdomen and aspirate the water.

Depending on whether a therapeutic or diagnostic puncture is to be performed, a small or a large proportion of the water in the abdomen is suctioned off. For a diagnostic puncture, the water is collected in a sterile tube. It can then be analyzed in the laboratory. To prevent further infection, the place where the needle was inserted is covered with a sterile drape.

Follow-up treatment and monitoring

In the follow-up treatment or monitoring of a puncture site with water in the abdomen, intensive care is usually not necessary. In order to continue to prevent infections, care should be taken to ensure that the puncture site is covered in a sterile manner and is not contaminated with dirt. If necessary, the bandage or plaster should be changed. Redness or pain are signs of infection. Furthermore, care should be taken that the puncture site heals well and that no water drips out of the stomach. If so, a tighter bandage or a small suture may be considered. The next day, some blood values are routinely checked by the laboratory.

These risks exist

If the water is punctured in the abdomen, there are some risks, some of which can have serious consequences. As a rule, however, only harmless complications arise. These include a slight external infection or slight secondary bleeding. This can be prevented with a little pressure or good hygiene. Often there is also a drop in blood pressure within the next 24 hours, which can lead to a deterioration in kidney function.

Furthermore, it can happen that liquid or further water emerges through the branch channel. This is less common. However, it is a risk factor for peritonitis. Peritonitis is a serious clinical picture and can lead to serious complications. If the course is severe, generalized inflammation, sepsis, can develop, with the risk of death.

Despite the control with the ultrasound device, organs or large vessels in the abdominal wall can be injured. This can cause consequential damage to some organs such as the intestine. If a vessel is injured, heavy bleeding occurs depending on its size. This also represents an important and serious risk. It can also lead to the development of an abscess. Finally, by suctioning off the water, water may again collect in the abdominal cavity with a slight delay. As a result, the body can lose other blood components such as electrolytes and proteins to a great extent in addition to water. They may need to be replaced.

You can repeat that so often

A puncture of the ascites can theoretically be repeated as often as required. Nevertheless, one should follow the advice of the doctors and leave enough time between the individual punctures. As a result of the puncture, the body loses not only water but also electrolytes and proteins, which must first be absorbed or formed again, unless they have been replaced by infusion.

Duration of the puncture

The duration of the puncture itself is not very long. However, with appropriate preparation and compliance with hygiene standards, it can sometimes take half an hour. The duration of the puncture itself depends on the amount of water. Usually, however, the puncture is over after a few minutes.

It's that painful

If the water is punctured in the abdomen, it is usually not painful. Although one is not given general anesthesia, no pain is felt because the surrounding tissue is numb from a local anesthetic. Only the syringe with which the local anesthetic is introduced can cause slight pain at the beginning. In retrospect, there may also be slight pain in the area of the puncture canal. In the case of therapeutic punctures, however, the puncture is perceived as a relief, as it reduces the pain caused by the high amount of water.

Read more on the subject at: Local anesthesia

Examination of the fluid in the ascites

As a rule, after the puncture, every ascension is analyzed by a laboratory in order to obtain information on pathological processes or bacteria. To do this, a small amount of the ascites is collected in special vessels. Various parameters are then determined. Among other things, the number of cells, the number or type of bacteria, the inflammation parameters, proteins, electrolytes or tumor markers are determined.

Permanent drainage

If water recurs in the abdomen, permanent drainage can also be used so that the puncture process is not repeated every time. For this purpose, as with a normal puncture, the abdominal wall is pierced with an indwelling venous cannula or needle. However, there is a tube around the needle that remains in the abdominal wall after the needle has been removed. It can also be introduced as part of a minor surgical procedure.

The tube, which is also called an indwelling catheter, creates a constant connection between the abdomen and the surface of the skin. A drainage system with a suitable vessel or bag for collecting the water can now be connected to this hose. The permanent connection to the abdominal cavity, however, represents an increased risk of complications. As an alternative, the abdominal fluid can also be permanently drained into the blood vessels through a shunt.

Indwelling catheter

The indwelling catheter is used to allow permanent drainage of the abdominal fluid in the event of recurring complaints. As already described, this is inserted into the abdominal wall and lingers there. It has a valve to regulate the outlet of the water. If necessary, a collection system can be connected to the indwelling catheter.