Ascites is when fluid accumulates within your abdomen causing it to distend and become uncomfortable. Effusions are fluid collections within the chest. The fluid in the chest and distension of the abdomen can affect your breathing as the fluid stops the diaphragm from being able to move properly and compresses the lung. Drainage of the fluid can help improve the situation.

What are Ascites and effusion drainage procedures?

Whilst medication can help reduce the swelling it can take several weeks to work. A simple interventional procedure under local anaesthetic can insert a small soft plastic tube into your abdomen or chest and drain the fluid out in a few hours. This gives immediate relief. This is called a paracentesis (abdomen) or Pleural drainage. Occasionally the fluid can re-accumulate quickly, in this situation it may be appropriate to insert a more permanent tunnelled soft plastic tube which remain in able to drain the fluid whenever necessary.

When might patients need drainage procedures?

The build up of fluid within the abdomen or chest can be very uncomfortable and compromise breathing. When quick relief is required a simple drainage procedure can help. This can be repeated if necessary but if the fluid keeps re-accumulating then a more permanent solution with a tunnelled drainage tube can be placed.

What happens during the drainage procedure?

The procedure is performed with image guidance typically using ultrasound. For a simple plastic tube insertion, sometimes known as a “pigtail catheter”, the procedure is performed under aseptic conditions with a local anaesthetic in the ultrasound room. After consent the skin is cleaned and draped with a sterile towel with a small central hole. A small needle is used to instill a small amount of local anaesthetic, which can sometimes sting a little, this only lasts about 20 seconds. Using ultrasound guidance a small needle is inserted into the abdomen or chest fluid collection. A small wire is then inserted to allow the pigtail catheter to be correctly inserted into the ascites or pleural fluid. The pigtail drain is then fixed and dressed and allowed to freely drain into an attached small bag.

How should I prepare?

There is often no preparation required and the procedure can be performed as an outpatient. However, occasionally if the fluid collection is large you will be admitted to a day-case bed to allow monitoring and to check for any bleeding complications.