Ascites other diagnostic studies: Difference between revisions
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{{Ascites}} | {{Ascites}} | ||
{{CMG}}; {{AE}} {{EG}} | |||
==Overview== | ==Overview== | ||
[[Paracentesis]] is sampling ascites fluid through [[abdominal wall]] with overall [[complication]] rate of not more than 1%. The sampled fluid will be surveyed upon total [[protein]] concentration, [[neutrophil]] count, and inoculation into [[blood culture]] bottles. | |||
== Other diagnostic studies == | |||
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===Paracentesis=== | |||
* [[Paracentesis]] is sampling ascites fluid through [[abdominal wall]] with overall [[complication]] rate of not more than 1%.<ref name="pmid2946271">{{cite journal |vauthors=Runyon BA |title=Paracentesis of ascitic fluid. A safe procedure |journal=Arch. Intern. Med. |volume=146 |issue=11 |pages=2259–61 |year=1986 |pmid=2946271 |doi= |url=}}</ref> | |||
* The sampled fluid will be surveyed upon:<ref name="pmid21455322">{{cite journal| author=Biecker E| title=Diagnosis and therapy of ascites in liver cirrhosis. | journal=World J Gastroenterol | year= 2011 | volume= 17 | issue= 10 | pages= 1237-48 | pmid=21455322 | doi=10.3748/wjg.v17.i10.1237 | pmc=3068258 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21455322 }}</ref> | |||
** Total [[protein]] concentration | |||
** [[Neutrophil]] count | |||
** Inoculation into [[blood culture]] bottles | |||
* [[Paracentesis]] findings include:<ref name="pmid10673079">{{cite journal |vauthors=Rimola A, García-Tsao G, Navasa M, Piddock LJ, Planas R, Bernard B, Inadomi JM |title=Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club |journal=J. Hepatol. |volume=32 |issue=1 |pages=142–53 |year=2000 |pmid=10673079 |doi= |url=}}</ref><ref name="pmid3417231">{{cite journal |vauthors=Runyon BA, Hoefs JC, Morgan TR |title=Ascitic fluid analysis in malignancy-related ascites |journal=Hepatology |volume=8 |issue=5 |pages=1104–9 |year=1988 |pmid=3417231 |doi= |url=}}</ref> | |||
** [[Protein]] concentration <1.5 g/dL is predictive of high risk for [[Spontaneous bacterial peritonitis|spontaneous bacterial peritonitis (SBP)]] | |||
** [[Neutrophil]] count of > 250 per mm<sup>3</sup> is diagnostic of [[SBP]] | |||
** Positive culture of ascites fluid is diagnostic of [[SBP]] | |||
** Measuring [[Serum-ascites albumin gradient|serum-ascites albumin gradient (SAAG)]] is also helpful for diagnosing the underlying disease | |||
=== Ascitic fluid measurements (American Association for the Study of Liver Diseases)<ref>{{Cite web|url=https://www.aasld.org/sites/default/files/guideline_documents/adultascitesenhanced.pdf|title=Management of Adult Patients with Ascites Due to Cirrhosis|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref> === | |||
{| class="wikitable" | |||
!Routine Tests | |||
!Optional (infection suspicion) | |||
!Unusual | |||
!Unhelpful | |||
|- | |||
| | |||
* Cell count and differential | |||
* [[Albumin]] | |||
* [[Total protein]] | |||
| | |||
* [[Culture collection|Culture]] | |||
* [[Glucose]] | |||
* [[Lactate dehydrogenase]] | |||
* [[Amylase]] | |||
* [[Gram's stain]] | |||
| | |||
* [[Acid fast|Acid fast bacterial]] stain and culture | |||
* [[Cytology]] | |||
* [[Triglyceride]] | |||
* [[Bilirubin]] | |||
| | |||
* [[pH]] | |||
* [[Lactic acid|Lactate]] | |||
* [[Cholesterol]] | |||
* [[Fibronectin]] | |||
* [[Glycosaminoglycan]] | |||
|} | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category: | [[Category: Medicine]] | ||
[[Category: Up-To-Date]] | |||
[[Category: Gastroenterology]] | |||
[[Category: Hepatology]] | |||
[[Category: Emergency medicine]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} |
Latest revision as of 13:30, 29 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
Paracentesis is sampling ascites fluid through abdominal wall with overall complication rate of not more than 1%. The sampled fluid will be surveyed upon total protein concentration, neutrophil count, and inoculation into blood culture bottles.
Other diagnostic studies
KVpwXK7cvzQ|600}} |
Paracentesis
- Paracentesis is sampling ascites fluid through abdominal wall with overall complication rate of not more than 1%.[1]
- The sampled fluid will be surveyed upon:[2]
- Total protein concentration
- Neutrophil count
- Inoculation into blood culture bottles
- Paracentesis findings include:[3][4]
- Protein concentration <1.5 g/dL is predictive of high risk for spontaneous bacterial peritonitis (SBP)
- Neutrophil count of > 250 per mm3 is diagnostic of SBP
- Positive culture of ascites fluid is diagnostic of SBP
- Measuring serum-ascites albumin gradient (SAAG) is also helpful for diagnosing the underlying disease
Ascitic fluid measurements (American Association for the Study of Liver Diseases)[5]
Routine Tests | Optional (infection suspicion) | Unusual | Unhelpful |
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|
|
References
- ↑ Runyon BA (1986). "Paracentesis of ascitic fluid. A safe procedure". Arch. Intern. Med. 146 (11): 2259–61. PMID 2946271.
- ↑ Biecker E (2011). "Diagnosis and therapy of ascites in liver cirrhosis". World J Gastroenterol. 17 (10): 1237–48. doi:10.3748/wjg.v17.i10.1237. PMC 3068258. PMID 21455322.
- ↑ Rimola A, García-Tsao G, Navasa M, Piddock LJ, Planas R, Bernard B, Inadomi JM (2000). "Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club". J. Hepatol. 32 (1): 142–53. PMID 10673079.
- ↑ Runyon BA, Hoefs JC, Morgan TR (1988). "Ascitic fluid analysis in malignancy-related ascites". Hepatology. 8 (5): 1104–9. PMID 3417231.
- ↑ "Management of Adult Patients with Ascites Due to Cirrhosis" (PDF).