PERCUTANEOUS NEEDLE PERITONEAL BIOPSY IN THE DIAGNOSIS OF EXUDATIVE ASCITES
AbstractBackground: Percutaneous needle peritoneal biopsy in diagnosis of exudative ascites has gained wideacceptance and many workers have utilized it with a high diagnostic yield and no significantcomplications. Present study has been carried out to determine the efficacy of percutaneous needleperitoneal biopsy in the diagnosis of exudative ascites of unknown aetiology. Methods: It is a descriptivecase study conducted in Medical ‘C’ Unit, Lady Reading Hospital, Postgraduate Medical Institute, KhyberMedical University Peshawar over a period of 2 years, i.e., from Nov, 2003 to December 2005. A total of45 patients having unexplained exudative ascites underwent blind needle peritoneal biopsy. The biopsyspecimen was subjected to histopathology. Ascitic fluid was also obtained for analysis. Post biopsypatients were observed for 24 hours for any untoward complications. Results: A total of 45 patients (17male and 28 female) with age range from 20 to 65 years and having exudative ascites were studied. Thecommonest presentation of our patients was abdominal distension (93.3%), pain abdomen (46.67%), fever(44.4%) and weight loss (33.3%). Histopathology of the peritoneal biopsies was reported as follows.Eighteen cases (40%) showed non specific chronic inflammation, 10 (22.2%) cases showed caseatinggranulomatous inflammation suggestive of tuberculosis and 6 (13.3%) cases showed metastaticadenocarcinoma. In one patient peritoneal mesothelioma was reported. In the remaining10 patients(22.2%) biopsies were either non representative or inconclusive. The ascitic fluid showed predominantlylymphocytes in 86.6% of cases. Only three patients were reported to be having atypical cells on fluidcytology. The procedure was found safe. No patient was lost due to complications related to theprocedure. Only one patient had evidence of intra peritoneal bleed. The commonest problem post biopsywas pain (91.1%) and mild swelling (53.3%) at biopsy site. Conclusion: Peritoneal biopsy is fairly safeand inexpensive procedure with good diagnostic efficacy in patients with undiagnosed exudative ascites.Keywords: Peritoneal biopsy, Diagnosis, Exudative ascites
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