Cytology – Peritoneal Fluid:
Why Cytology – Peritoneal Fluid Test?
CLINICAL INFORMATION
Peritoneal fluid is a serous fluid made by the peritoneum in the abdominal cavity which lubricates the surface of tissue that lines the abdominal wall and pelvic cavity. The primary function of peritoneal fluid is to reduce friction between the abdominal organs as they move around during digestion. While any pathology of the abdomen in chronic stages develop ascites. Ascitic Fluids found in certain diseases and many infections eg. TB and chronic diseases such as liver cirrhosis cause accumulation of fluid in the peritoneal cavity. Thus ascitic fluid accumulated in the cavity and leads to Ascites. An ascitic Fluid test is done to detect peritonitis. Hence peritoneal fluid analysis is used to help diagnose the cause (Transudate or exudate) of fluid build-up in the abdomen (ascites) peritonitis. Transudate and Exudate -This test detects the cause of effusion (such as infection due to bacteria, virus, fungi etc, or non-infectious / inflammatory condition causing peritonitis eg. congestive heart failure, nephrotic syndrome, hepatic cirrhosis, pancreatitis, ruptured gall bladder, rupture of the appendix, autoimmune diseases etc – Transudate or Exudate) of fluid accumulated in the peritoneal cavity and sometimes around the internal organs. High attenuation of ascites in abdominal ultrasound is thought to be due to high protein and cellular content. Therefore cytological studies on the ascetic sample specimen are of immense importance. It helps in differential diagnosis to rule out other possibilities as a source of disease. The microscopic examination helps to differentiate the difference between the malignancy (presence of malignant cells like undifferentiated cells) or inflammatory cells (presence of WBCs that reflects inflammation). Hence the cytological microscopic test report guides the mode of the therapy suitable for the patient’s current presenting complaint. It also monitors the prognosis and the recurrence of the disease. Peritonitis is a medical emergency and if untreated by neglect the infection from the peritoneum can spread throughout the body known as sepsis which is a life-threatening condition that consequently leads to shock, organ failure and eventually death. Signs of peritonitis include abdominal pain or tenderness, bloating or feeling of fullness in the abdomen, fever, nausea and vomiting, loss of appetite, diarrhoea, low urine output and thirst. Complications of ascites are spontaneous bacterial peritonitis (a life-threatening infection), blood sepsis, migration of fluid into lung cavities, hepato-renal syndrome, weight loss and protein malnutrition, mental confusion, altered consciousness. Change in level of alertness and/or COMA (hepatic-encephalopathy). Additional supporting tests for ascites performed are clinically based for ascetic fluid are by inspection for bulging flanks, auscultation, percussion, palpation. Clinical examination by palpation, flank dullness, shifting dullness etc., for performing ascetic tap, elevated jugular venous pressure, fluid wave, puddle sign etc, are tested. Conformational tests for ascites include ultrasound and imaging studies like X-Rays, MRI, CT Scan etc. Other tests include cell counts, biochemical investigations such as liver function tests (to check impaired liver function), coagulation tests etc (treatment modalities and the prognosis also requires monitoring of blood biochemistry eg. Electrolytes), bacterial culture and PCR. Cytology of Peritoneal Fluid: Cytology is a study that examines the study of cells under a microscope. Hence a cytological examination of aspirated peritoneal fluid also helps in identifying the presence of harmful infectious micro-organisms along with inflammatory cells like WBCs etc, on microscopic evaluation. The identification of the infectious causative agent is thus identified (eg. Gram-positive or Gram-negative) to arrive at a definite diagnosis for starting effective medication (such as broad-spectrum or narrow-spectrum antibiotics) against it. Additional tests include ESR, CRP, D-dimer etc.
General Instructions:
Sample Requirement: Specimen – Peritoneal Fluid. Test Preparation: None.
NOTE - Sample for specimen collections may vary based on the patient’s condition/cases according to the patient’s presenting complaints/signs or symptoms:
SPECIMEN REQUIREMENT (Special or Rare Cases) - As instructed and guided by Physician / Clinician / Pathologist / as per Laboratory’s requirements, according to procedures and protocols.
This Multi-Specialty Clinical Referral Laboratory RTDIAGNOSTICS provides precise and accurate tests with an extensive range of testing services to the medical centres to help in the diagnosis and identification of pathology in the test specimens for infectious diseases and also to evaluate the function of organ systems of the patient. It prevents further complications and helps to stabilize and restore health to near normalcy at the earliest without delay.
