Ascites Drainage and Long-Term Drainage Catheter Placement

Therapeutic paracentesis is indicated when ascites fluid has accumulated enough to cause respiratory compromise, abdominal pain, or worsening of existing inguinal or umbilical hernias. Paracentesis should not be performed to diagnose the presence of ascites fluid. This should be known prior to the procedure (by physical examination or radiological imaging). Paracentesis is a procedure to remove fluid that has accumulated in the abdominal cavity (peritoneal fluid), a condition called ascites. Most common causes of ascites are cirrhosis of the liver, cancer, and congestive heart failure. Paracentesis may be done to:

  • Determine the cause of fluid buildup in the abdominal cavity (ascites).
  • Diagnose infection in the peritoneal fluid.
  • Detect certain types of cancer, such as liver cancer.
  • Remove a large amount of fluid that is causing pain or difficulty breathing or that is affecting the function of the kidneys or the intestines (bowel).
  • Evaluate abdominal injury.

When there is potential for reaccumulation of the fluid on a regular bases your doctor may recommend that a long term drainage catheter be placed on your abdomen. This is an innovative approach to home management of pleural effusions. The catheter is a short tube with drainage holes which is inserted into the chest cavity by an Interventional Radiologist. The end of the catheter protrudes through the skin and has a valve that prevents leakage of fluid when not in use. This end is protected by a dressing that ensures comfort and discretion.

Pleurx Catheter Placement

The Pleurx Catheter is typically placed via a minimally invasive outpatient procedure in a hospital or clinic setting. Patients need a driver. Patients need to return in 4-5 days to have sutures removed.

The drainage procedure can be repeated whenever necessary depending on the severity of the symptoms, usually every 2-3 days. The catheter can remain in the body for many months. The drainage procedure is quick and pain-free as no further injections are required.

What do I do to prepare?

You need to designate a primary care giver who can come with you on the day of your appointment to receive the teaching of how to drain the fluid and perform wound care. We will review how to drain the fluid and how much to drain. Please record how much you drain when you go home so you can inform your physician. Your primary physician may consider arranging for the Home Health Services to come in to help out as well. We need to assure once we place the tube that there is someone in the home that can drain the fluid if you are unable to yourself.

What happens during the procedure?

Conscious sedation is provided just prior to the start of the procedure. You will be connected to several types of monitoring equipment. You will lie on an X-ray table. The technologist will prepare the skin over the affected area, cleaning it with an antiseptic solution and place sterile drapes and towels over you to create a sterile work space. The Interventional Radiologist will use Ultrasound guidance to insert the catheter. Then, he will X-ray it to make sure it is in the optimum position for fluid drainage. You will have a small incision close to where the tube comes out with a couple of sutures that will need to be removed in 4-6days.

What happens after the proceduree?

Since conscious sedation medicine is administered you will be required to stay to recover for 2 hours. You and your family will go to the recovery area. You will be able to eat and drink if you wish. Prior to you going home we will give your designated care giver the opportunity to drain the fluid off.

We have made some adaptations to the collection system we will give you the option to you the system we have been using for 5 years or you can choose to use the collection products from Denver Biomedics.

Web Site for more information regarding Pleurx catheter:

If you have any questions or need to reschedule an appointment please feel free to contact the Interventional Radiology Office at 802-847-8359. Our business hours are Monday - Friday, 8:30 a.m. to 5 p.m. Someone is available to take your call after hours for emergencies.

This information is provided by the Fletcher Allen Health Care, Department of Radiology, Division of Interventional Radiology and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact your health care provider.