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Home Paracentesis Quality of Life — SCE Palliative Medicine MCQ

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HardNon-Malignant Palliative CareHome Paracentesis Quality of LifeSCE Palliative Medicine

A patient with recurrent malignant ascites needs drainage every ten days and wishes to remain at home. There is no loculation or active peritonitis. Which option best reduces repeated hospital procedures?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Tunnelled peritoneal catheter supported by community nursing review

Explanation lettering: C = shown as A · D = shown as B · A = shown as C · B = shown as D

D is correct. In selected patients with treatment-resistant recurrent malignant ascites, a tunnelled catheter can permit intermittent community drainage, reduce repeat hospital visits and give control over symptom timing. Suitability includes goals, prognosis, home support, infection and loculation assessment and ability to manage the device. A transfers an invasive procedure to untrained relatives. B uses a short-term device with greater infection and displacement risk. C overstates diuretic benefit in malignant ascites. E ignores demonstrable symptomatic relief. Drainage volume and frequency are individualised to avoid hypotension, leakage and renal deterioration.

Reference: NICE MTG9: PleurX peritoneal catheter for malignant ascites: https://www.nice.org.uk/guidance/mtg9/chapter/1-Recommendations