The accumulation of a large amount of fluid in the space between the internal organs or the cavity of the small pelvis is a symptom of many serious diseases. For their diagnosis, the abdominal puncture is performed. It can be carried out in 2 ways, depending on the purpose of the procedure and the expected pathology. In most cases, paracentesis (abdominal puncture of the abdomen) is carried out, less often access is obtained through the posterior vaginal vault - culdocentesis (only in women).
Diagnostic and therapeutic abdominal puncture
If it is necessary to check the nature of the fluid accumulating in the space between the digestive organs, a diagnostic paracentesis is performed.
The abdominal puncture site is thoroughly disinfected, treated with anesthetics (usually - injections of novocaine). After this, the surgeon, as a rule, under the control of ultrasound, introduces a special trocar, through which the existing liquid flows. The first portions of the biological material are collected in a sterile tube and sent to a laboratory. The zone with damaged skin is covered with an antiseptic dressing or surgical sutures , 1-2 pieces, with silk thread.
Therapeutic abdominal puncture with ascites suggests the same puncture, but after taking the liquid for analysis, it continues to be pumped into the reservoir. For 1 procedure you can remove up to 6 liters of biomaterial. During such manipulation it is necessary to restore the loss of salts and proteins, so the patient is additionally injected with albumin or other identical solutions.
Puncture of abdominal cavity through posterior vaginal vault
Kuldotsentez is necessary for the diagnosis and therapy of gynecological diseases, when fluid accumulates in the space between the organs of the small pelvis. There may be pus, blood and exudate, so it is important to examine the resulting material immediately.
Indications for abdominal puncture through the posterior vaginal vault are few:
- probability of ectopic pregnancy (ectopic);
- suspicion of a progressive abscess in the pelvic cavity.
It is important to note that modern surgeons are less likely to use cul-docentesis because of the high risk of secondary infection of the puncture site. Other methods of research, for example, laparoscopy, have similar informativeness. This method is less traumatic and rarely causes complications, so it is preferable.