A Case of Large, Hemodynamically Significant Abdominal Wall Hematoma Following Paracentesis in a Cirrhotic Patient

Paracentesis is a safe procedure with severe bleeding occurring in less than 1% of cases. Paracentesis is often times performed as an outpatient procedure. Hemorrhagic complications can be rapidly fatal if not diagnosed and treated in a timely fashion. We present the case of a 55-year-old female with decompensated cirrhosis who developed hemodynamically significant bleeding post paracentesis. This case brings up the question whether certain patients who undergo paracentesis should be admitted for close observation for at least 24 hours after the procedure. It also identifies the need for more research into pre-operative risk factors in cirrhotics that predisposes them to severe bleeding.