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close this bookMinor Surgical Procedures in Remote Areas (MSF, 1989, 172 p.)
close this folderChapter 3: Catheterisation and drainage
View the documentCatheterisation of large veins
View the documentLumbar puncture
View the documentPleural puncture
View the documentThoracic drainage
View the documentPericardial puncture
View the documentDrainage of ascites and intra-peritoneal perfusion
View the documentPuncture and drainage of the knee

Drainage of ascites and intra-peritoneal perfusion

· Drainage of fluid in the peritoneum ection of intra-peritoneal perfusion

Indications

· 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.

Material

Large trocar or short large bore catheter (18 G for exemple).

Technique

Figure 66

· 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.


FIGURE