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Diagnostic Paracentesis

Diagnostic Paracentesis Abstract The value and safety of simple needle tap of the abdominal cavity has long been recognized as an aid in the differential diagnosis of the acute abdomen. Despite its value, the procedure has failed to gain general acceptance. This lack of acceptance may be based upon an unjustified fear of puncturing the bowel, or it may be due to the unreliability of former techniques. A survey of the literature combined with our experience in more than 100 cases has served to dispel concern over the rare occurrence of entering the bowel lumen. Diagnostic paracentesis should be considered only as another test to aid in the construction of a more definite, clear-cut clinical picture. This is especially evident in the differential diagnosis of complex or unusual problems associated with intraperitoneal disease or traumatic injury. In many instances the results of a tap are conclusively self-explanatory and the clinical problem is at References 1. Anderson, U. S.: The Study of Peritoneal Exudates , Journal-Lancet 61:430-433 ( (Oct.) ) 1941. 2. Campbell, H. E.: Abdominal Puncture: A Practical Aid in Diagnosis , Rocky Mountain M. J. 43:305-307 ( (April) ) 1946. 3. Cole, W. H.: Pneumococcus Peritonitis , Surgery 1:386-394 ( (March) ) 1937. 4. Denzer, B. S.: A New Method of Diagnosis of Peritonitis in Infancy and Childhood: Preliminary Report , Am. J. Dis. Child. 20:113-114 ( (Aug.) ) 1920.Crossref 5. Denzer, B. S.: Abdominal Puncture in the Diagnosis of Peritonitis in Childhood , J. Pediat. 8:741-747 ( (June) ) 1936.Crossref 6. Frink, N. W.: Abdominal Puncture as a Diagnostic Aid , Permanente Found. M. Bull. 4:129-133 ( (July) ) 1946. 7. Henry, C. M., and Vale, C. F.: Abdominal Puncture as a Diagnostic Aid , Surgery 14:574-577 ( (Oct.) ) 1943. 8. Hill, F. C.; O'Loughlin, B. J., and Stoner, M.: Peritoneal Aspiration in the Diagnosis of Strangulated Bowel , Surg. Gynec. & Obst. 74:121-123 ( (Jan.) ) 1942. 9. Hilliard, G. W., and Nash, H. E., Jr.: Cellular Composition of the Peritoneal Fluid in DBA Mice After Intraperitoneal Injection of Normal and Malignant Human Cells , J. Lab. & Clin. Med. 38:846-849 ( (Dec.) ) 1951. 10. Horsley, J. S.: Peritonitis , Arch. Surg. 36:190-224 ( (Feb.) ) 1938. 11. Kaufman, L. R.; Eckes, W. P., and Mule, J.: Peritoneal Tap , Arch. Surg. 49:39-43 ( (July) ) 1944. 12. Keith, L. M., Jr.; Zollinger, R. M., and McCleery, R. S.: Peritoneal Fluid Amylase Determinations as an Aid in Diagnosis of Acute Pancreatitis , Arch. Surg. 61:930-936 ( (Nov.) ) 1950. 13. Ladd, W. E.; Botsford, T. W., and Curnen, E. C.: Primary Peritonitis in Infants and Children: A More Effective Treatment , J. A. M. A. 113:1455-1459 ( (Oct. 14) ) 1939. 14. Meeroff, M.: Diagnostic Puncture of the Abdomen , Presna méd. argent. 37:2748-2753 ( (Nov. 10) ) 1950. 15. Moretz, W. H., and Erickson, W. G.: Peritoneal Tap as an Aid in Diagnosis of Acute Abdominal Disease , Am. Surgeon 20:363-377 ( (April) ) 1954. 16. Neuhof, H., and Cohen, I.: Abdominal Puncture in the Diagnosis of Acute Intraperitoneal Disease , Ann. Surg. 83:454-462 ( (April) ) 1926. 17. di Paola, G.: Diagnostic Puncture in Gynecology , Día méd. 19:2461-2467 ( (Dec. 22) ) 1947. 18. Pfeffer, R. B.; Mixter, G., and Hinton, J. W.: Acute Hemorrhagic Pancreatitis: A Safe. Effective Technique for Diagnostic Paracentesis , Surgery 43:550-554 ( (April) ) 1958. 19. Scott, H. G., and Wangensteen, O. H.: Length of Life Following Various Types of Strangulation Obstruction in Dogs , Proc. Soc. Exper. Biol. & Med. 29:424-427 ( (Jan.) ) 1932. 20. Salomon, H.: The Diagnostic Puncture of the Abdomen , Berl. klin. Wchnschr. 43:45-46, 1906. 21. Steinberg, B.: Peritoneal Exudate: A Guide for the Diagnosis and Prognosis of Peritoneal Conditions , J. A. M. A. 116:572-578 ( (Feb. 15) ) 1941.Crossref 22. Thompson, C. T., and Brown, D. R.: Diagnostic Paracentesis in the Acute Abdomen , Surgery 35:916-919 ( (June) ) 1954. 23. Touroff, A. S. W.: Peritoneal Aspiration as Aid in the Diagnosis of Acute Appendicitis , S. Clin. North America 19:287-294 ( (April) ) 1939. 24. Villafane, I. Z.: Diagnostic Puncture of Abdomen , Bol. y trab., Soc. argent. cirujanos 5:1160-1161, 1944. 25. Villafane, I. Z.: Abdominal Puncture in the Diagnosis and Evaluation of Acute Pancreatitis , Prensa méd. argent. 34:2337-2339 ( (Dec. 5) ) 1947. 26. Villafane, I., and Maggi, O.: Abdominal Puncture in the Diagnosis of False Acute Abdomen , Bol. y trab., Soc. argent cirujanos 9:206-223. 1948. 27. Wangensteen, O. H.: Intestinal Obstructions: A Physiological and Clinical Consideration with Emphasis on Therapy; Including Description of Operative Procedures , Ed. 2, Springfield, Ill., Charles C Thomas, Publisher, 1942, pp. 57, 115. 28. Weakley, S. D., Jr., and Clegg, C. B.: Diagnostic Value of Paracentesis in the Acute Surgical Condition of the Abdomen , Am. J. Surg. 93:802-806 ( (May) ) 1957.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1958 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1958.01290050029006
Publisher site
See Article on Publisher Site

Abstract

Abstract The value and safety of simple needle tap of the abdominal cavity has long been recognized as an aid in the differential diagnosis of the acute abdomen. Despite its value, the procedure has failed to gain general acceptance. This lack of acceptance may be based upon an unjustified fear of puncturing the bowel, or it may be due to the unreliability of former techniques. A survey of the literature combined with our experience in more than 100 cases has served to dispel concern over the rare occurrence of entering the bowel lumen. Diagnostic paracentesis should be considered only as another test to aid in the construction of a more definite, clear-cut clinical picture. This is especially evident in the differential diagnosis of complex or unusual problems associated with intraperitoneal disease or traumatic injury. In many instances the results of a tap are conclusively self-explanatory and the clinical problem is at References 1. Anderson, U. S.: The Study of Peritoneal Exudates , Journal-Lancet 61:430-433 ( (Oct.) ) 1941. 2. Campbell, H. E.: Abdominal Puncture: A Practical Aid in Diagnosis , Rocky Mountain M. J. 43:305-307 ( (April) ) 1946. 3. Cole, W. H.: Pneumococcus Peritonitis , Surgery 1:386-394 ( (March) ) 1937. 4. Denzer, B. S.: A New Method of Diagnosis of Peritonitis in Infancy and Childhood: Preliminary Report , Am. J. Dis. Child. 20:113-114 ( (Aug.) ) 1920.Crossref 5. Denzer, B. S.: Abdominal Puncture in the Diagnosis of Peritonitis in Childhood , J. Pediat. 8:741-747 ( (June) ) 1936.Crossref 6. Frink, N. W.: Abdominal Puncture as a Diagnostic Aid , Permanente Found. M. Bull. 4:129-133 ( (July) ) 1946. 7. Henry, C. M., and Vale, C. F.: Abdominal Puncture as a Diagnostic Aid , Surgery 14:574-577 ( (Oct.) ) 1943. 8. Hill, F. C.; O'Loughlin, B. J., and Stoner, M.: Peritoneal Aspiration in the Diagnosis of Strangulated Bowel , Surg. Gynec. & Obst. 74:121-123 ( (Jan.) ) 1942. 9. Hilliard, G. W., and Nash, H. E., Jr.: Cellular Composition of the Peritoneal Fluid in DBA Mice After Intraperitoneal Injection of Normal and Malignant Human Cells , J. Lab. & Clin. Med. 38:846-849 ( (Dec.) ) 1951. 10. Horsley, J. S.: Peritonitis , Arch. Surg. 36:190-224 ( (Feb.) ) 1938. 11. Kaufman, L. R.; Eckes, W. P., and Mule, J.: Peritoneal Tap , Arch. Surg. 49:39-43 ( (July) ) 1944. 12. Keith, L. M., Jr.; Zollinger, R. M., and McCleery, R. S.: Peritoneal Fluid Amylase Determinations as an Aid in Diagnosis of Acute Pancreatitis , Arch. Surg. 61:930-936 ( (Nov.) ) 1950. 13. Ladd, W. E.; Botsford, T. W., and Curnen, E. C.: Primary Peritonitis in Infants and Children: A More Effective Treatment , J. A. M. A. 113:1455-1459 ( (Oct. 14) ) 1939. 14. Meeroff, M.: Diagnostic Puncture of the Abdomen , Presna méd. argent. 37:2748-2753 ( (Nov. 10) ) 1950. 15. Moretz, W. H., and Erickson, W. G.: Peritoneal Tap as an Aid in Diagnosis of Acute Abdominal Disease , Am. Surgeon 20:363-377 ( (April) ) 1954. 16. Neuhof, H., and Cohen, I.: Abdominal Puncture in the Diagnosis of Acute Intraperitoneal Disease , Ann. Surg. 83:454-462 ( (April) ) 1926. 17. di Paola, G.: Diagnostic Puncture in Gynecology , Día méd. 19:2461-2467 ( (Dec. 22) ) 1947. 18. Pfeffer, R. B.; Mixter, G., and Hinton, J. W.: Acute Hemorrhagic Pancreatitis: A Safe. Effective Technique for Diagnostic Paracentesis , Surgery 43:550-554 ( (April) ) 1958. 19. Scott, H. G., and Wangensteen, O. H.: Length of Life Following Various Types of Strangulation Obstruction in Dogs , Proc. Soc. Exper. Biol. & Med. 29:424-427 ( (Jan.) ) 1932. 20. Salomon, H.: The Diagnostic Puncture of the Abdomen , Berl. klin. Wchnschr. 43:45-46, 1906. 21. Steinberg, B.: Peritoneal Exudate: A Guide for the Diagnosis and Prognosis of Peritoneal Conditions , J. A. M. A. 116:572-578 ( (Feb. 15) ) 1941.Crossref 22. Thompson, C. T., and Brown, D. R.: Diagnostic Paracentesis in the Acute Abdomen , Surgery 35:916-919 ( (June) ) 1954. 23. Touroff, A. S. W.: Peritoneal Aspiration as Aid in the Diagnosis of Acute Appendicitis , S. Clin. North America 19:287-294 ( (April) ) 1939. 24. Villafane, I. Z.: Diagnostic Puncture of Abdomen , Bol. y trab., Soc. argent. cirujanos 5:1160-1161, 1944. 25. Villafane, I. Z.: Abdominal Puncture in the Diagnosis and Evaluation of Acute Pancreatitis , Prensa méd. argent. 34:2337-2339 ( (Dec. 5) ) 1947. 26. Villafane, I., and Maggi, O.: Abdominal Puncture in the Diagnosis of False Acute Abdomen , Bol. y trab., Soc. argent cirujanos 9:206-223. 1948. 27. Wangensteen, O. H.: Intestinal Obstructions: A Physiological and Clinical Consideration with Emphasis on Therapy; Including Description of Operative Procedures , Ed. 2, Springfield, Ill., Charles C Thomas, Publisher, 1942, pp. 57, 115. 28. Weakley, S. D., Jr., and Clegg, C. B.: Diagnostic Value of Paracentesis in the Acute Surgical Condition of the Abdomen , Am. J. Surg. 93:802-806 ( (May) ) 1957.Crossref

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Dec 1, 1958

References

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