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Troubleshooting Paracentesis Using POCUS.
Angelina Voronina1,2, Nachelle Aurelien1, Edward Bergin1,3
1Department of General Internal Medicine, Section of Hospital Medicine, Weill Cornell Medical Center.
Point of care ultrasound (POCUS) can help resolve obstructed flow during paracentesis when bowel adheres to the catheter. This report proposes an algorithm to manage this common complication, improving procedural success.
Area of Science:
- Medical Procedures
- Diagnostic Imaging
- Gastroenterology
Background:
- Paracentesis is a common bedside procedure for ascites management.
- Point of care ultrasound (POCUS) reduces paracentesis complications.
- Intraprocedural POCUS for catheter obstruction is underdescribed.
Observation:
- Two cases presented where bowel adhered to the paracentesis catheter, obstructing flow.
- POCUS was utilized to visualize and address the catheter obstruction.
- Literature review and procedural experience informed the proposed solution.
Findings:
- Adherence of bowel to the centesis catheter is a frequent cause of flow obstruction.
- POCUS can effectively guide interventions to restore catheter patency.
- A systematic algorithm is proposed to manage this specific complication.
Implications:
- Implementing the proposed POCUS-guided algorithm can improve paracentesis success rates.
- This approach may reduce the need for repeat procedures or alternative interventions.
- Enhanced POCUS utilization can optimize bedside paracentesis management.
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