Recipient(s) will receive an email with a link to 'Other Body Fluids: Pleural, Pericardial, and Peritoneal Spaces' and will have access to the topic for 7 days.
Subject: Other Body Fluids: Pleural, Pericardial, and Peritoneal Spaces
(Optional message may have a maximum of 1000 characters.)
Under normal conditions, a very small amount of fluid (up to 50 mL) is present. This facilitates movement of membranes against each other. Abnormal fluid accumulation is called a serous effusion. In the presence of effusions, fluid can be aspirated from the affected cavity, either for diagnosis or for relief of pressure, commonly both. Finding substantial amounts of fluid always reflects a pathologic process.
Cloudiness: neutrophils present, indicating infection
Milkiness: chylous effusion
Bloody: traumatic tap, malignancy, pneumonia, trauma, status postmyocardial infarction, or pulmonary infarction
Cell counts and differentials
WBC count >1 × 109/L with lymphocytes >50%: TB, cancer, lymphoma, CLL
WBC count >1 × 1010/L with approximately 80% neutrophils: effusions associated with bacterial pneumonia
WBC with eosinophilia: postpneumothorax, trauma, hypersensitivity reactions, CHF, fungal and parasitic infections, SLE, Hodgkin lymphoma
Bloody: pericarditis, status postmyocardial infarction, TB, RA, SLE, carcinoma, aspiration of blood from the cardiac cavity
Cell counts and differential
WBC count 1 × 109/L with increased lymphocytes: pericardial tuberculosis
WBC count 1 × 109/L with increased neutrophils: bacterial or viral pericarditis
Cloudy or turbid: appendicitis, pancreatitis, intestinal volvulus, ruptured bowel, sepsis
Bile-stained: perforated duodenal ulcer, perforated intestine, gallbladder disease or perforation, acute pancreatitis
Milky: chylous effusion
Bloody: traumatic tap, intra-abdominal injury
Cell counts and differential on lavage fluid
RBC count >1 × 1011/L: intra-abdominal injury
WBC count 0.5 × 109/L: possible peritonitis
Cell counts and differential on undiluted ascitic fluid
WBC count 0.3 × 109/L: bacterial peritonitis if >50% neutrophils, cirrhosis of the liver if <25% neutrophils
Increased lymphocytes: tuberculous peritonitis
Increased eosinophils: CHF, hypereosinophilic syndrome, eosinophilic gastroenteritis, chronic peritoneal dialysis, abdominal lymphoma, ruptured hydatid cyst, vasculitis
All cell counts should be performed promptly to prevent cell deterioration; distorted or degenerated cells should not be counted.
Specimens with large clots cannot be processed.