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Analysis of fluid from the abdominal cavity
Last reviewed: 23.04.2024
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The total number of leukocytes in the ascites fluid in chronic liver diseases is less than 300 cells in 1 μl (in 50% of cases), neutrophilic leukocytes are less than 25% (in a third of cases).
With peritonitis of infectious etiology, the total number of leukocytes is more than 500 cells per 1 μl (sensitivity is more than 80%, specificity is 98%), neutrophilic leukocytes make up more than 50%.
At microscopic examination, erythrocytes are detected in tuberculous peritonitis, portal vein thrombosis and mesenteric vessels, peritoneal malignant tumors, traumatic injuries. A large number of white blood cells occurs with purulent peritonitis, a large number of lymphocytes - with chronic tuberculous peritonitis. The presence of atypical cells, especially in the form of clusters, is characteristic of neoplasms of the peritoneum.
Criteria for the diagnosis of penetrating abdominal wounds according to peritoneal lavage data:
- the number of erythrocytes more than 10 000 in 1 μl (more than 5000 in 1 μl for gunshot wounds);
- the number of leukocytes is more than 500 in 1 μl or the presence of bile, stool, or bacteria when stained with Gram stain.
Criteria for diagnosis of blunt abdominal injuries according to peritoneal lavage data:
- the number of erythrocytes is more than 100,000 in 1 μl;
- the number of leukocytes is less than 500 in 1 μl;
- the activity of α-amylase is more than 2 times higher than the upper limit of the norm.
The criteria for the presence of urine in the abdominal cavity (in the presence of fistulas of the urinary tract) - the concentration of urea and creatinine in the ascitic fluid is more than 2 times higher than in the serum.
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