Peritoneal fluid analysis

Definition:
A test to examine fluid which has accumulated in the peritoneal space (the abdominal space that houses the gastrointestinal organs). The sample is obtained by the procedure of abdominal tap (paracentesis).

How the test is performed:
A sample of fluid is obtained by abdominal tap. The physician(s) will sterilize and then numb a small area of your abdomen with a small needle. Next, a larger needle will be inserted into the peritoneal space and the fluid will be withdrawn. Occasionally, vacuum bottles are used to draw off large amounts of fluid. The fluid is typically examined in the laboratory for appearance, red and white blood cell counts, protein and albumin, bacteria and fungi. Occasionally assays for glucose, amylase, ammonia, alkaline phosphatase, LDH, cytology, and other substances are performed.
How to prepare for the test:
You must sign a consent form. Immediately before the abdominal tap, empty your bladder.

Infants and children:
The physical and psychological preparation a parent can provide for this or any test or procedure depends on the child's age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How the test will feel:
There may be a stinging sensation from the anesthetic and a feeling of pressure as the needle is inserted. If a large amount of fluid is withdrawn, you may have a feeling of dizziness or light-headedness. Tell the health care provider if you become dizzy.
Why the test is performed:
The test is performed to determine the cause of fluid (ascites) in the abdomen, to detect whether trauma has caused internal bleeding, to detect a perforation (hole) of the bladder, and to detect peritonitis.
What abnormal results mean:
Milk-colored peritoneal fluid may indicate disease such as carcinoma, lymphoma, tuberculosis or infection. Bloody fluid may indicate tumor or trauma. Bile-stained fluid may indicate gallbladder problems. High white blood cell counts may indicate peritonitis or cirrhosis. Other laboratory abnormalities may indicate abnormalities in the intestinal or abdominal organs. Large differences between the concentration of albumin in the peritoneal fluid and the concentration in the serum may point to heart, liver or kidney failure as the cause of the fluid collection. Small differences may point more towards malignancy or infection.
What the risks are:
There is a slight chance of the needle puncturing the bowel, bladder, or a blood vessel in the abdomen. If a large quantity of fluid is removed, there is a slight risk of low blood pressure and even shock. There is also a slight chance of infection.

Review Date: 11/16/2001
Reviewed By: Steven Angelo, M.D., Dept. of Internal Medicine, Yale School of Medicine, Hospital of Saint Raphael, New Haven, CT. Review provided by VeriMed Healthcare Network.
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