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Peritoneal fluid is a serous fluid made by the peritoneum in the abdominal cavity which lubricates the surface of tissue that lines the abdominal wall and pelvic cavity. It covers most of the organs in the abdomen. An increased volume of peritoneal fluid is called ascites. Sampling of peritoneal fluid is generally performed by paracentesis.
Cytopathology of peritoneal fluid from paracentesis , showing typical features of adenocarcinoma. It is used for a number of reasons: [3] to relieve abdominal pressure from ascites; to diagnose spontaneous bacterial peritonitis and other infections (e.g. abdominal TB) to diagnose metastatic cancer; to diagnose blood in peritoneal space in trauma
The increase in hydrostatic pressure causes more fluid to leave the circulation into the peritoneal space (ascites). The SAAG subsequently increases because there is more free fluid leaving the circulation, concentrating the serum albumin. The albumin does not move across membrane spaces easily because it is a large molecule.
This procedure is performed when intra-abdominal bleeding (hemoperitoneum), usually secondary to trauma, is suspected. [2]In a hemodynamically unstable patient with high-risk mechanism of injury, peritoneal lavage is a means of rapidly diagnosing intra-abdominal injury requiring laparotomy, but has largely been replaced in trauma care by the use of a focused assessment with sonography for ...
Ascites (/ ə ˈ s aɪ t i z /; [5] Greek: ἀσκός, romanized: askos, meaning "bag" or "sac" [6]) is the abnormal build-up of fluid in the abdomen. [1] Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. [4]
In medicine, the fluid wave test or fluid thrill test is a test for ascites (free fluid in the peritoneal cavity). It is performed by having the patient (or a colleague) push their hands down on the midline of the abdomen. The examiner then taps one flank, while feeling on the other flank for the tap.
Initial management consists of immediate blood transfusion if the patient is in hemorrhagic shock. Classically, hemoperitoneum was an indication for emergency surgery to locate the source of bleeding and also to recover spilled blood from the peritoneal cavity and to use it for auto-transfusion if it has not been contaminated by ruptured bowel contents.
The diagnosis of SBP requires paracentesis, a sampling of the peritoneal fluid taken from the peritoneal cavity. [6] If the fluid contains large numbers of white blood cells known as neutrophils (>250 cells/μL), infection is confirmed and antibiotics will be given, without waiting for culture results. [7]