Pathology: anatomic pitfalls for paracentesis

Observe the location of the inferior epigastric artery (IEA, in red).  This is one of the anatomic danger zones one must consider when selecting a location for paracentesis.  Other landmarks include bladder, spleen and liver. 

A good bet is to choose a lateral position, such as the anterior axillary line, and follow it downward towards the umbilicus.  This should help avoid sticking a needle into the IEA.

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