Ascites other diagnostic studies: Difference between revisions

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Latest revision as of 13:30, 29 January 2018

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

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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
Cell count and differential Albumin Total protein	Culture Glucose Lactate dehydrogenase Amylase Gram's stain	Acid fast bacterial stain and culture Cytology Triglyceride Bilirubin	pH Lactate Cholesterol Fibronectin Glycosaminoglycan

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).

Template:WH Template:WS

[pmid2946271-1] Runyon BA (1986). "Paracentesis of ascitic fluid. A safe procedure". Arch. Intern. Med. 146 (11): 2259–61. PMID 2946271.

[pmid21455322-2] 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.

[pmid10673079-3] 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.

[pmid3417231-4] Runyon BA, Hoefs JC, Morgan TR (1988). "Ascitic fluid analysis in malignancy-related ascites". Hepatology. 8 (5): 1104–9. PMID 3417231.

[5] "Management of Adult Patients with Ascites Due to Cirrhosis" (PDF).

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@@ Line 2: / Line 2: @@
 {{Ascites}}
-Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.
+{{CMG}}; {{AE}} {{EG}}
 ==Overview==
-==Paracentesis==
+[[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.
-For a detailed approach on performing paracentesis watch the video below:
-{{#ev:youtube|bdnGQYfQhNA}}
+== Other diagnostic studies ==
+{| align="right"
+|{{#ev:youtube|KVpwXK7cvzQ|600}}
+|}
+===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==
 {{Reflist|2}}
-[[Category:Needs content]]
+[[Category: Medicine]]
+[[Category: Up-To-Date]]
+[[Category: Gastroenterology]]
+[[Category: Hepatology]]
+[[Category: Emergency medicine]]
 {{WH}}
 {{WS}}