Table 20.4-1. Peritoneal fluid analysis

Analyte

Result and interpretation

ADA

≥40 IU/L

Suggestive of tuberculosis

Albumin, [S] – [P]

≥11 g/L

Portal hypertension, cirrhosis, alcoholic hepatitis, multiple metastases to the liver, heart failure

<11 g/L

Peritoneal metastases, tuberculosis, pancreatitis, serositis, nephrotic syndrome

Protein, total

<10 g/L

Increased risk of spontaneous bacterial peritonitis in cirrhosis

≥10 g/L

Peritonitis secondary to esophageal perforation

Glucose, [P]/[S]

<1.0

WBCs, bacteria, and neoplastic cells in the fluid; glucose levels may be indeterminable in esophageal perforation

LDH, [P]/[S]

~0.4

Ascites without complications in cirrhosis

>1.0

Infection, malignancy

Amylase, [P]/[S]

>1.0

Pancreatic diseases, ~6.0 in esophageal perforation, ~0.4 in ascites without complications in cirrhosis

Bilirubin, [P]/[S]

>1.0

Bile duct perforation

Triglycerides

>2.26 mmol/L

(200 mg/dL)

Chyloperitoneum, often >11 mmol/L (1000 mg/dL)

ADA, adenosine deaminase; [P]/[S], concentration in the peritoneal fluid divided by serum concentration; [S] – [P], serum concentration minus concentration in the peritoneal fluid; WBC, white blood cell.