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Paracentesis is a medical procedure whereby a catheter or a needle is inserted to drain fluid from a body cavity. More often than not, this procedure is carried out in the peritoneal cavity in the abdomen. The purpose of this procedure is to obtain ascitic fluid so that it can be diagnosed and treatment started on the patient. This paracentesis procedure also helps to relieve pressure in the abdomen. Paracentesis fluid analysis is carried out for a number of reasons. These include:-

1. To diagnose metastatic cancer.
2. To diagnose infections such as abdominal tuberculosis and other infections.
3. To diagnose blood in the peritoneal cavity.
4. To diagnose spontaneous bacteria peritonitis.

Paracentesis fluid studies help with all of the above. While paracentesis fluid analysis is carried out under medical supervision and in a laboratory, paracentesis itself can be performed either in an outpatient clinic or in a doctor's office. There is a very slight risks associated with this procedure. These could be infection, or perforation of a loop of the bowel or even excessive bleeding. The procedure for paracentesis is as follows. The patient is asked to lie down and the head of the bed is raised. Local anesthesia is administered and the doctor then inserts the needle into the abdominal cavity to remove the fluid, which is then sent for paracentesis fluid analysis. The fluid which is removed is known as peritoneal or ascitic fluid. Up to 11 liters of fluid can be taken out during one procedure. The procedure is not very painful and patients are allowed to go back home if they do not feel dizzy or have any problems with their blood pressure after the procedure. Hypotension may occur if the fluid is drained too rapidly.

Paracentesis fluid color may be as given below:-

• Typically the color ranges between transparent to clear to cloudy yellow.
• It could also be dark brown or milky or bloody in appearance.

Paracentesis fluid analysis involves testing for albumen and protein, cytology, cell count and differential, LD, bacterial culture, glucose, triglycerides, ascites fluid PH, Gram's stain, amylase, special cultures for tuberculosis and fungi, CEA, and hyaluronic acid. After paracentesis fluid analysis is carried out , the fluid is either classified as transudative or exudative. This difference of transudate from exudates is done by characterizing the ascites in the SAAG also called as serum-ascitic albumin gradient. The value is achieved by finding the difference between the concentration of albumin in the ascitic fluid and the concentration of albumin of a serum specimen.