Disclaimer

ACEP makes every effort to ensure that contributors to College-sponsored programs are knowledgeable authorities in their fields. Participants are nevertheless advised that the statements and opinions expressed in this article are provided as guidelines and should not be construed as College policy. The material contained herein is not intended to establish policy, procedure, or a standard of care. The views expressed in this article are those of the contributors and not necessarily the opinion or recommendation of ACEP. The College disclaims any liability or responsibility for the consequences of any actions taken in reliance on those statements or opinions.

[/fullbar]

References

1. Williams JW, Simel DL. The rational clinical examination. Does this patient have ascites? How to divine fluid in the abdomen. JAMA. 1992;267(19):2645-2648.
2. Goldberg BB, Clearfield HR, Goodman GA, et al. Ultrasonic determination of ascites. Arch Intern Med. 1973;131(2):217-220.
3. Giacobene JW, Siler VE: Evaluation of diagnostic abdominal paracentesis with experimental and clinical studies. SurgGynecolObstet1960;110:676-686.
4. Bard C, Lafortune M, Breton G. Ascites: ultrasound guidance or blind paracentesis? CMAJ. 1986;135(3):209-210.
5. Nazeer SR, Dewbre H, Miller AH. Ultrasound-assisted paracentesis performed by emergency physicians vs the traditional technique: a prospective, randomized study. Am J Emerg Med. 2005;23(3):363-367.
6. Cattau EL Jr, Benjamin SB, Knuff TE, Castell DO. The accuracy of the physical examination in the diagnosis of suspected ascites. JAMA. 1982;247(8):1164.
7. Patel PA, Ernst FR, Gunnarsson CL. Evaluation of hospital complications and costs associated with using ultrasound guidance during abdominal paracentesis procedures. J Med Econ. 2012;15(1):1-7. Epub 2011 Oct 19.
8. Runyon BA. Diagnostic and therapeutic paracentesis. UpToDate. 8 Sep 2011. Web. 15 June 2012.
9. Runyon BA; AASLD Practice Guidelines Committee. Management of adult patients with ascites due to cirrhosis: an update. Hepatology. 2009 Jun;49(6):2087-107.
10. Runyon BA, Montano AA, Akriviadis EA, Antillon MR, Irving MA, McHutchison JG. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med. 1992 Aug 1;117(3):215-20.
11. Shlamovitz GZ, Paracentesis. Medscape. 9 May 2012. Web. 10 June 2012.
12. Hwang JQ, Kimberly HH, Liteplo AS, Sajed D. An Evidence-Based Approach To Emergency Ultrasound. Emergency Medicine Practice. Mar 2011.
13. Promes SB. Chapter 54. Paracentesis. In: Reichman EF, Simon RR, eds. Emergency Medicine Procedures. New York: McGraw-Hill; 2004. http://www.accessemergencymedicine.com/content.aspx?aID=51430. Accessed June 11, 2012.
14. Dewitz A, Jones R, Goldstein J. Chapter 20. Additional Ultrasound-Guided Procedures. In: Blaivas M, Ma OJ, Mateer JR, eds. Emergency Ultrasound. 2nd ed. New York: McGraw-Hill; 2008. http://www.accessemergencymedicine.com/content.aspx?aID=105418. Accessed June 11, 2012.

CME Questionnaire Available Online

The CME test and evaluation form based on this article are located online at www.ACEP.org/focuson.