• • Diagnostic sampling of ascitic fluid (eg, internal bleeding following blunt abdominal trauma, chylous ascites after surgery, rule out malignancy, identification of infectious organism in spontaneous bacterial peritonitis).

  • Therapeutic removal of the ascitic fluid (eg, chylous ascites, tense ascites, intestinal lymphangiectasia).

Absolute

• • Unstable airway.

  • Hemodynamically unstable patient.

  • Intestinal perforation.

Relative

• • Infection of the abdominal wall.

  • Coagulopathy (prothrombin time > 18 seconds).

  • Thrombocytopenia (platelet count < 100,000/mcL).

  • Recent intestinal tract surgery (< 1 month ago).

• • Alcohol swabs, povidone-iodine.

  • 23-gauge and 21-gauge needles or angiocatheters with syringes.

  • Local anesthetic (eg, 1% lidocaine).

  • Large bore needle with plastic catheter.

  • Sterile containers for fluid collection.

  • Appropriate culture tubes for microorganisms.

• • Pneumoperitoneum.

  • Perforation: Intestine, solid organs.

  • Bleeding.

  • Infection.

• • Explain indication and risks to the patient and parents.

  • Inform the patient of the intention of the procedure.

• • Supine or side.