What is an Abdominal Tap: Procedures, Risks, Recovery, Outlook

An abdominal tap, also known as an abdominal paracentesis, is a procedure that removes excess fluid from the abdominal cavity. The abdominal cavity is the area located between the abdominal wall and the spine. The presence of excess fluid in the abdomen is known as ascites. Under normal circumstances, there should be no fluid present in the abdominal cavity, and if there is fluid present, then it can lead to pain, bloating, and breathing difficulties.

The most common cause of fluid in the abdominal cavity is the fibrotic scarring of the liver, known as cirrhosis. Fluid accumulation in the abdominal cavity can also be due to many types of illnesses, including:

• Pancreatitis
• Tuberculosis
• Cancer
• An infection
• Kidney disease
• Bowel disease
• Heart failure, also known as congestive heart failure

An abdominal tap not only removes the excess fluid from the abdominal cavity but also finds out the cause of this fluid accumulation. ⁽¹⁾

According to the American College of Gastroenterology ⁽²⁾, people with liver disease who also develop ascites, have a 30 to 40 percent chance of surviving the next five years. A liver transplant becomes necessary at this stage.

An abdominal tap can be performed either in your doctor’s office or in the hospital. You are not supposed to eat or drink anything at least 12 hours before the procedure. You will also need to have an empty bladder for the procedure.

It takes around 15 to 20 minutes to complete an abdominal tap, and there is no requirement for general anesthesia.

An abdominal tap is performed in the following steps:

Step 1: The procedure area is shaved and cleaned.

Step 2: The doctor will then apply a local anesthetic to numb the area to prevent any pain or discomfort to the patient. If there is a large quantity of fluid to be removed, then the doctor will need to make a small cut in the skin to allow the needle to pass through.

Step 3: Once the area is prepped, the doctor will insert the needle tap into the skin. This needle only goes 1 to 2 inches deep, and the fluid is then extracted with the syringe.

Step 4: The doctor will then remove the needle. An ultrasound may or may not be used during the tap. The amount of fluid that is removed depends on the original purpose of the abdominal tap. Your doctor might need to perform a small diagnostic tap or a large-volume tap. During a large-volume abdominal tap, several liters of fluid will be removed to reduce the pain and pressure. In this case, a tube might also be attached between the syringe and needle to help the doctor take out more fluids.

After the procedure is completed, your doctor will dress up your wound and, if needed, also put in any necessary stitches. If further diagnosis is required, then the fluid that has been withdrawn will be submitted to the laboratory.

It is rare to have any risks associated with an abdominal tap, but the most common risks include minor trouble while breathing and some leakage of fluid immediately after the procedure. Typically, you will need to wait to leave the hospital or the doctor’s office until these complications clear up.

Some other potential risks include:

• An infection
• An acute kidney injury
• A drop in blood pressure, which only happens if there is a significant volume of fluid removed
• An accidental puncture of a blood vessel, the bladder, or the bowel

Some risk factors increase the risk of complications, especially if you also have cirrhosis. You are also likely to develop an infection if you drink too much alcohol or if you are a smoker. Poor nutrition also increases the risk of infection.

Once you reach back ho0me, you should inform your doctor immediately if you develop any of these symptoms:

• Chills
• Fever
• Bleeding
• Increased pain
• Swelling and redness around the needle puncture site
• Leakage of fluid
• Cough
• Chest pain
• Shortness of breath
• Fainting
• Increased swelling around the abdomen

It is not normal to have an excess buildup of fluid in the abdominal cavity. This is why an abdominal tap is required for removing this built-up fluid and also determine the cause of this fluid buildup. Recovering from an abdominal tap is straightforward, ⁽³⁾ and you can go back to your daily activities once the wound heals. You should check with your doctor about any exercise and physical activities that you can perform after the tap, especially if you have stitches.

The outlook of an abdominal tap depends on the underlying cause of the fluid buildup. Depending on your overall condition, you might have to undergo multiple abdominal taps, especially if the fluid continues to build up.

References

1. McCoy, J. and Wolma, F.J., 1971. Abdominal tap: Indication, technic, and results. The American Journal of Surgery, 122(5), pp.693-695.
2. American College of Gastroenterology. (2019). Ascites: A Common Problem in People with Cirrhosis – American College of Gastroenterology. [online] Available at: http://patients.gi.org/topics/ascites/ [Accessed 13 Oct. 2019].
3. Fairview.org. (2019). Discharge Instructions for Paracentesis. [online] Available at: https://www.fairview.org/sitecore/content/Fairview/Home/Patient-Education/Articles/English/d/i/s/c/h/Discharge_Instructions_for_Paracentesis_40926 [Accessed 13 Oct. 2019].