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Peritoneal fluid analysis

  • Definition
    • Peritoneal fluid analysis is a lab test to look at fluid that has built up in the space in the abdomen around the internal 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). A needle is inserted through the skin of your abdomen and a fluid sample is pulled out. The fluid is collected into a tube (syringe) attached to the end of the needle.

      The fluid is sent to a lab 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.

      The following tests may also be 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 medicines (including herbal remedies)
      • Have any allergies to medicines 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 placed.

      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
    • Abnormal results may 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.

  • Risks
    • Risks may include:

      • 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, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 153.

      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: Elsevier Saunders; 2010:chap 91.