title: Feasibility of sonographic localization of the inferior epigastric artery before ultrasound-guided paracentesis.
abstract: BACKGROUND
  Ultrasound-guided paracentesis is commonly performed in the emergency department (ED) setting. Injury to the inferior epigastric artery (IEA) is an uncommon but potentially life-threatening complication of paracentesis. Use of anatomic landmarks has been recommended to avoid this structure. If feasible, sonographic localization of the IEA before ultrasound-guided paracentesis may provide the operator with anatomic mapping of this vascular structure.
  
  
  METHODS
  We present 5 cases demonstrating the feasibility of identifying the IEA in ED patients with ascites. Why should an emergency physician be aware of this? Sonographic localization of the IEA before ultrasound-guided paracentesis may provide a more reliable means of avoiding iatrogenic injury to this vessel. Further study is warranted to determine whether routine IEA visualization before paracentesis results in a decreased complication rate.
authors.affiliation: Department of Emergency Medicine, University of Virginia Health System, PO Box 800699, Charlottesville, VA 22908 USA. Electronic address: jstone341@gmail.com.
authors.forename: Justin C
authors.initials: JC
authors.lastname: Stone
authors.affiliation: Department of Emergency Medicine, University of Virginia Health System, PO Box 800699, Charlottesville, VA 22908 USA.
authors.forename: James H
authors.initials: JH
authors.lastname: Moak
mesh_terms: D000328:Adult; D000368:Aged; D001201:Ascites / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D019074:Epigastric Arteries / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019152:Paracentesis; D018084:Ultrasonography, Interventional