Polymorphonuclear count in ascitic fluid after laparotomy in cirrhotic patients.
In order to establish whether an ascitic polymorphonuclear count greater than 250/mm3 remains a diagnostic criterion for postoperative bacterial peritonitis, a prospective study of 16 patients with cirrhosis and ascites undergoing hepatectomy (n = 4), portocaval shunt (n = 5) and biliary and digestive surgery (n = 7) was carried out. Sixty-four consecutive specimens of ascitic fluid were obtained through abdominal one-way suction tubes left in situ. In 17 (26%) specimens, ascitic fluid was blood stained and the polymorphonuclear count was unreliable; none of these specimens demonstrated positive ascitic fluid culture. In the remaining 47 specimens the polymorphonuclear count ranged from 5 to 5,920/mm3. Positive ascitic fluid culture was significantly higher in polymorphonuclear > or = 250/mm3 group (5/13: 38%) than in polymorphonuclear < 250/mm3 group (2/34: 6%) (p < 0.02). These results suggest that, as in non-operated cirrhotic patients: (a) polymorphonuclear count should be taken in account in the diagnosis of postoperative bacterial peritonitis; (b) polymorphonuclear count greater than 250/mm3 is a good criterion for the diagnosis of bacterial postoperative peritonitis.
Belghiti
J
J
Service de Chirurgie, Hôpital Beaujon, Clichy, France.
Panis
Y
Y
Chiche
R
R
Faivre
E
E
Fékété
F
F
D001202:Ascitic Fluid / Q000166:cytology*; D006498:Hepatectomy; D006801:Humans; D007958:Leukocyte Count; D008103:Liver Cirrhosis / Q000601:surgery*; D009504:Neutrophils; D010538:Peritonitis / Q000175:diagnosis*; D011170:Portasystemic Shunt, Surgical; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies