Peritoneal fluid analysis

Answer 1

Definition

Peritoneal fluid analysis is a laboratory test to examine fluid that has collected in in the area of the abdomen that contains the gastrointestinal organs. This area is called the peritoneal space.

How the test is performed

The sample of fluid is removed from the periotoneal space using a needle and syringe.

The health care provider will clean and numb a small area of your belly area (abdomen). Next, the doctor inserts a needle through the skin of your abdomen, and into the peritoneal space, and withdraws a sample of fluid. The fluid collects into a tube (syringe) attached to the end of the needle.

See: Abdominal tap

The fluid is sent to a laboratory where it is examined. Tests will be done on the fluid to measure red and white blood cell counts, protein, and albumin, and to check for bacteria and fungi. Occasionally, tests for glucose, amylase, ammonia, alkaline phosphatase, LDH, cytology, and other substances are done.

How to prepare for the test

Let your health care provider know if you have any Allergies to medications or numbing medicine, are taking any medications (including herbal remedies), have any bleeding problems, or might be pregnant.

How the test will feel

You may feel a stinging sensation from the numbing medicine, or pressure as the needle is inserted.

If a large amount of fluid is withdrawn, you may have dizziness or lightheadedness. Tell the health care provider if you feel dizzy.

Why the test is performed

The test is performed to determine the cause of fluid in the abdomen, to detect whether injury has caused internal bleeding, and to detect peritonitis.

It is also done to remove large amounts of fluid from the peritoneal space in people who have liver disease.

What abnormal results mean

• Bile-stained fluid may mean you have a gallbladder problem.
• Bloody fluid may indicate tumor or injury.
• High white blood cell counts may be a sign of peritonitis.
• Milk-colored peritoneal fluid may be a sign of carcinoma, lymphoma, tuberculosis,or infection.

Other laboratory abnormalities may be due to a problem in the intestines or abdominal organs. Large differences between the concentration of albumin in the peritoneal fluid and in your blood may point to heart, liver, or kidney failure. Small differences may suggest towards cancer or infection.

What the risks are

• Damage to the bowel, bladder, or a blood vessel in the abdomen from a needle puncture
• Infection
• Low blood pressure
• Shock

References

Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 157.

Answer 2

Definition

Peritoneal fluid analysis is a laboratory test to examine fluid that has collected in the area of the abdomen that contains the gastrointestinal organs. This area is called the peritoneal space.

How the test is performed

The sample of fluid is removed from the peritoneal space using a needle and syringe.

Your health care provider will clean and numb a small area of your belly area (abdomen). Next, your health care provider will insert a needle through the skin of your abdomen into the peritoneal space, and pull out a sample of fluid. The fluid collects into a tube (syringe) attached to the end of the needle.

See: Abdominal tap

The fluid is sent to a laboratory where it is examined. Tests will be done on the fluid to measure:

• Albumin
• Protein
• Red and white blood cell counts

Tests will also check for bacteria and other types of infection.

Sometimes, the following tests are also done:

• Alkaline phosphatase
• Amylase
• Cytology(appearance of cells)
• Glucose
• LDH

How to prepare for the test

Let your health care provider know if you:

• Are taking any medications (including herbal remedies)
• Have any allergies to medications or numbing medicine
• Have any bleeding problems
• Might be pregnant

How the test will feel

You may feel a stinging sensation from the numbing medicine, or pressure as the needle is inserted.

If a large amount of fluid is taken out, you may feel dizzy or light-headed. Tell the health care provider if you feel dizzy.

Why the test is performed

The test is done to:

• Detect peritonitis
• Find the cause of fluid in the abdomen
• Remove large amounts of fluid from the peritoneal space in people who have liver disease
• See whether an injury to the abdomen has caused internal bleeding

What abnormal results mean

• Bile-stained fluid may mean you have a gallbladder or liver problem.
• Bloody fluid may be a sign of tumor or injury.
• High white blood cell counts may be a sign of peritonitis.
• Milk-colored peritoneal fluid may be a sign of carcinoma, cirrhosis of the liver, lymphoma, tuberculosis, or infection.

Other abnormal test results may be due to a problem in the intestines or organs of the abdomen. Large differences between the amount of albumin in the peritoneal fluid and in your blood may point to heart, liver, or kidney failure. Small differences may be a sign of cancer or infection.

What the risks are

• Damage to the bowel, bladder, or a blood vessel in the abdomen from a needle puncture
• Infection
• Low blood pressure
• Shock

References

Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 157.

Runyon BA. Ascites and spontaneous bacterial peritonitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 91.

Reviewed By

Review Date: 02/04/2011

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.