RT Book, Section
A1 Pfennig, Camiron L.
A1 Brown, B. Ethan
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181053124
T1 Peritoneal Fluid
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181053124
RD 2024/04/18
AB Cirrhosis,  cancer,  heart  failure,  tuberculosis,  and  dialysis  account  for  97%  of  cases  of  ascites,  the  accumulation  of  fluid  within  the  peritoneal  cavity.  Paracentesis  is  performed  when  the  ascites  is  new  or  the  cause  of  the  ascites  is  unclear  (diagnostic  tap)  or  when  the  patient  becomes  symptomatic  (abdominal  pain,  shortness  of  breath,  fever)  (therapeutic  tap).  Gross  appearance  of  peritoneal  fluid  provides  a  clue  to  the  cause  of  the  ascites.  Uncomplicated  ascitic  fluid  in  cirrhosis  is  transparent  and  yellow.  Ascitic  fluid  can  be  completely  clear  if  the  bilirubin  is  normal.  Turbid  or  cloudy  fluid  suggests  infection  (peritonitis)  (see  Figs.  25.60  and  25.61).  Milky  fluid  has  a  high  triglyceride  level  and  is  considered  chylous  ascites.  Pink  or  bloody  fluid  is  due  to  a  “traumatic  tap,”  which  clears  over  time,  or  malignancy,  which  is  heterogeneous.