Which lab tests are performed in the evaluation of fluid from paracentesis?

Updated: Jul 05, 2018
  • Author: Gil Z Shlamovitz, MD, FACEP; Chief Editor: Vikram Kate, MBBS, MS, PhD, FRCS, FACS, FACG, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS  more...
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Depending on the clinical situation, fluid may be sent for the following laboratory tests:

  • Gram stain - In a retrospective review of 796 peritoneal fluid samples, the evaluation of Gram stain results rarely provided clinically useful information for the detection of spontaneous bacterial peritonitis [14]
  • Cell count (elevated counts may suggest infection)
  • Bacterial culture
  • Total protein level
  • Triglyceride levels (elevated in chylous ascites)
  • Bilirubin level (may be elevated in bowel perforation)
  • Glucose level
  • Albumin level, used in conjunction with serum albumin levels obtained the same day (used to calculate SAAG; see the Ascites Albumin Gradient calculator)
  • Amylase level (elevation suggests pancreatic source)
  • Lactate dehydrogenase (LDH) level
  • Cytology

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