Ascites is an abnormal increase in fluid within the peritoneal (abdominal) cavity. The normal abdominal cavity has a small amount of fluid (usually less than 150 mL). Cirrhosis (chronic liver disease) with associated portal hypertension (blood pressure within the liver above the normal range of five to eight mm Hg) is the most common cause of ascites. Other causes of ascites include cancer, heart failure, kidney failure, tuberculosis and pancreatic disease. An abdominal paracentesis involves the surgical puncture of the abdominal cavity with a needle and placement of a catheter line for the removal of excess fluid. The procedure can be diagnostic in helping identify the cause of ascites or may be used as a therapeutic measure if a large volume of fluid can be removed to lessen discomfort and improve breathing. The March 12, 2008, issue of JAMA includes an article about paracentesis techniques. It identifies ways to decrease the risk of complications and to improve diagnostic accuracy.
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