Paracentesis and thoracentesis in the emergency department

Meet the patient

A man with known cirrhosis presents with increasing abdominal swelling, mild abdominal pain and new confusion. His INR is raised and his platelets are low. A second patient on the next bed has a large unilateral pleural effusion and is breathless.

Who needs a tap. Paracentesis should be performed in any patient with ascites and concern for spontaneous bacterial peritonitis or upper gastrointestinal bleeding, or who is being admitted for a complication of cirrhosis; the presentation may be abdominal pain, worsening ascites, fever or altered mental status, but some patients are asymptomatic or only mildly symptomatic.^[13]

References18ShowHide

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