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Where should ascitic drains be placed? Revisiting anatomical landmarks for paracentesis
- Source :
- Gut. 70:2216-2217
- Publication Year :
- 2021
- Publisher :
- BMJ, 2021.
-
Abstract
- We welcome the recent publication of the BSG/BASL guidelines on the management of ascites in cirrhosis which will serve as a framework for patient management across the world.1 Following clinician feedback on Twitter,2 we wish to respectfully highlight concerns regarding their guidance on landmarks for therapeutic paracentesis. Our first concern relates to the description of the landmarks. The authors recommend this to be βat least 8 cm (laterally) from the midline and 5 cm above the symphysis (pubis)β.1 This was predicated on three studies (two laparoscopic; one cadaveric) on the anatomical course of the inferior epigastric artery.3β5 While this approach avoids puncturing the vessel, there remains a risk of injury to underlying solid organs which can result in haemorrhage or perforation. Of note, these studies may not be generalisable to patients with distortion of β¦
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
2019-20 coronavirus outbreak
Coronavirus disease 2019 (COVID-19)
Symphysis
Perforation (oil well)
03 medical and health sciences
0302 clinical medicine
Ascites
medicine
Paracentesis
Humans
medicine.diagnostic_test
business.industry
General surgery
Gastroenterology
Patient management
030104 developmental biology
medicine.anatomical_structure
Drainage
030211 gastroenterology & hepatology
medicine.symptom
Cadaveric spasm
business
Subjects
Details
- ISSN :
- 14683288 and 00175749
- Volume :
- 70
- Database :
- OpenAIRE
- Journal :
- Gut
- Accession number :
- edsair.doi.dedup.....84effd0162e1f72224723ed845b1fd0d