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Paracentesis

Persons with malignant pleural mesothelioma experience symptoms that generally involve the lungs and the pleura, which is the lining of the lungs. However, when the disease progresses and metastasizes, it can affect other parts of the body as well, including the abdomen. Often, fluid will build up in the belly much as it does in the pleural spaces, and treatment becomes necessary for this condition. Generally, a procedure known as paracentesis is recommended for this purpose.

What is Paracentesis?

Very similar to thoracentesis, which removes fluid from the pleural area, paracentesis involves the removal of peritoneal fluid from the abdomen or belly. While the procedure can be used for diagnostic reasons – such as to diagnose cancer metastases – for pleural mesothelioma patients it is generally employed to alleviate abdominal pressure caused by fluid build-up (ascites).  

Like thoracentesis, this procedure involves draining the fluid via the insertion of a long, thin needle into the abdominal area. Once the fluid is removed, pressure is reduced and the patient will be much more comfortable. Paracentesis is, therefore, considered a palliative procedure as it reduces the symptoms of mesothelioma and makes the patient more comfortable and, in many cases, able to carry on with everyday tasks with more ease.

What Pleural Mesothelioma Patients Can Expect

Prior to scheduling a paracentesis, your doctor may order some imaging tests to verify the presence of fluid. These may include an X-ray, CT scan or MRI.

In most cases, this procedure is done in a doctor’s office but may be performed in a hospital setting if the patient is already there being treated for something else connected to the disease. A local anesthesia will be used so that the area is numb, but patients are usually awake during the procedure.

The patient may be asked to lie on his back though some doctors prefer the patient to be on their side or in another position. Once the doctor is satisfied that the area is numb, he or she will insert a long, thin needle into the abdomen and the fluid will be removed by means of a syringe.

Depending on how much fluid needs to be removed, the procedure should take no more than about 15 minutes. There are few complications associated with paracentesis and no pain is felt while it is being performed. Afterwards, there may be some mild discomfort.

In most cases, the patient remains in the presence of the doctor for an hour or two after the procedure in order to monitor excess drainage or to detect difficulty breathing or other potential concerns. Once home, the patient should rest and be diligently aware of any problems including fever and/or chills, swelling or pain at the paracentesis site, chest pain, cough, or shortness of breath. If any of these symptoms arise, the doctor should be contacted immediately or the patient should proceed to the nearest emergency room.

Sources:

1. http://www.webmd.com/brain/paracentesis-17042
2. http://emedicine.medscape.com/article/80944-overview