|Minor Surgical Procedures in Remote Areas (MSF, 1989, 172 p.)|
|Chapter 3: Catheterisation and drainage|
· Drainage of fluid in the peritoneum ection of intra-peritoneal perfusion
· Drainage of ascitic fluid is indicated principally for diagnostic purposes or when respiration is impaired. Drain slowly. Attach a drainage tube and container to the trochar, do not remove more than 1 liter per episode.
· Intra - peritoneal perfusion: indicated when there is difficult access to a vein, to avoid loosing time while waiting for venous access, for example in children with acute dehydration. Do not perfuse more than 70 ml/kg, perfuse slowly and use only sodium chloride or ringer lactate.
Large trocar or short large bore catheter (18 G for exemple).
· Rigorous asepsis: clean the abdomen with polyvidone iodine (see table page 7).
· Single puncture, perpendicular to the abdomen, on a line joining the umbilicus and the anterior superior iliac spine, usually on the left, to avoid perforation of the cecum; on the right in the case of massive splenomegaly.