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Peritoneal fluid analysis

Paracentesis; Abdominal tap

Peritoneal fluid analysis is a lab test. It is done 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. The condition is called ascites.

The test is also known as paracentesis or abdominal tap.

How the Test is Performed

The sample of fluid is removed from the peritoneal space using a needle and syringe. Ultrasound is often used to direct the needle to the fluid.

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 provider know if you:

  • Are taking any medicines (including herbal remedies)
  • Have any allergies to medicines or numbing medicine
  • Have any bleeding problems
  • Are pregnant or planning to get 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 lightheaded. Tell the 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. (This is done to make breathing comfortable.)
  • See whether an injury to the abdomen has caused internal bleeding.

What Abnormal Results Mean

Abnormal results may mean:

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
  • Bleeding
  • Infection
  • Low blood pressure
  • Shock

References

Chernecky CC, Berger BJ. Paracentesis (peritoneal fluid analysis) - diagnostic. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:849-851.

Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 153.

Miller JH, Moake M. Procedures. In: The Johns Hopkins Hospital; Hughes HK, Kahl LK, eds. The Harriet Lane Handbook. 21st ed. Philadelphia, PA: Elsevier; 2018:chap 3.

Runyon BA. Ascites and spontaneous bacterial peritonitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 93.

  • Diagnostic peritoneal lavage - series

    Diagnostic peritoneal lavage - series

    Presentation

  • Peritoneal culture

    Peritoneal culture - illustration

    A peritoneal culture is a procedure where peritoneal fluid is withdrawn with a needle from the peritoneal cavity. The peritoneal cavity is the space between the two membranes lining the abdominal cavity. The test is done to determine the cause of ascites, fluid accumulation in the peritoneal space.

    Peritoneal culture

    illustration

    • Diagnostic peritoneal lavage - series

      Presentation

    • Peritoneal culture

      Peritoneal culture - illustration

      A peritoneal culture is a procedure where peritoneal fluid is withdrawn with a needle from the peritoneal cavity. The peritoneal cavity is the space between the two membranes lining the abdominal cavity. The test is done to determine the cause of ascites, fluid accumulation in the peritoneal space.

      Peritoneal culture

      illustration

    Tests for Peritoneal fluid analysis

     

     

    Review Date: 1/1/2019

    Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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