Peritoneal Fluid Analysis

Peritoneal Fluid Analysis

Article
Digestive Health
Laboratory Procedures
+2
Contributed byMaulik P. Purohit MD MPHAug 07, 2019

What are the other Names for this Test? (Equivalent Terms)

  • Ascites Fluid Analysis Test 

What is Peritoneal Fluid Analysis? (Background Information)

  • The peritoneum is a protective membrane that encapsulates the abdominal cavity. It is continuous and two-sided. The cavity formed between the two sides is filled with a fluid that helps lubricate the abdominal organs
  • The inner side is the visceral peritoneum. The outer side is the parietal peritoneum. Between these layers float the peritoneal fluid
  • The mesothelial cells produce peritoneal fluid. Normally, they do so in small amounts. However, during irritation and infection, the membranes may become inflamed and peritoneal fluid may accumulate
  • Excessive peritoneal fluid is called ascites. It may interfere with the proper functioning of the digestive organs. It may also cause a variety of symptoms including swelling, tenderness, and discomfort
  • Peritoneal fluid is a pale yellow color fluid and consists of mainly cells, proteins, and other tissue factors. However, this composition may change with certain conditions. Such conditions may include:
    • Transudate: Slow leakage of dilute fluid into the peritoneal cavity due to osmotic and hydrostatic pressure imbalances. Common causes include high blood pressure and puncturing of the membrane
    • Exudate: Rapid leakage of concentrated fluid into the peritoneal cavity due to an active immune response. A common cause of this is inflammation from an infection 

The Peritoneal Fluid Analysis evaluates several characteristics of the peritoneal fluid. These include:

  • Appearance: Color, turbidity, and other visual properties
  • Alkaline phosphatase: Enzyme associated with liver and gallbladder function
  • Glucose
  • Presence of microorganisms: Indicated by a Gram stain, acid-fast stain, and amylase levels
  • Red blood cell count
  • White blood cell count
  • Cytology: Scanning for the presence of abnormal-looking cells

What are the Clinical Indications for performing the Peritoneal Fluid Analysis?

Following are the clinical indications for performing a Peritoneal Fluid Analysis:

  • As a follow-up to a finding of ascites
  • Abdominal pain and tenderness
  • Abdominal trauma
  • Fever
  • Fatigue
  • Nausea
  • Vomiting
  • Bloating of abdomen

How is the Specimen Collected for Peritoneal Fluid Analysis?

Following is the specimen collection process for Peritoneal Fluid Analysis Test:

Sample required: Peritoneal fluid

Process: Insertion of a needle through the peritoneum (peritoneocentesis).

Preparation required: No special preparation is needed prior to the test. 

What is the Significance of the Peritoneal Fluid Analysis Result?

The significance of Peritoneal Fluid Analysis is explained:

  • Increased peritoneal fluid levels may indicate:
    • Abdominal malignancy
    • Cirrhosis
    • Bacterial peritonitis
    • Gastric strangulation
    • Pancreatic pseudocyst
  • Decreased peritoneal fluid levels may indicate:
    • Abdominal malignancy
    • Tuberculosis 

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results based on the overall clinical scenario. 

Additional and Relevant Useful Information:

  • Certain factors interfere with the results of the Peritoneal Fluid Analysis test. These include food and fluid consumption, 6 hours prior to testing 

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

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Maulik P. Purohit MD MPH picture
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Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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