title: Ascitic fluid bilirubin concentration as a key to choleperitoneum.
abstract: Total bilirubin concentration was measured in the ascitic fluid and serum of 65 patients with various types of ascites to determine the normal range of these parameters. The mean (+/- SD) ascitic fluid bilirubin was 0.7 +/- 0.8 mg/dl, and the mean ascitic fluid/serum bilirubin ratio was 0.38 +/- 0.44. Subsequently, I recognized choleperitoneum in a patient with bile-stained ascites preoperatively, because the ascitic fluid bilirubin was 18.5 mg/dl and the ratio was 7.1. Laparotomy documented a ruptured gallbladder. An ascitic fluid bilirubin concentration greater than 6 mg/dl with an ascitic fluid/serum bilirubin ratio greater than 1.0 appears to be characteristic of choleperitoneum.
authors: Department of Medicine, Long Beach Veterans Administration Medical Center, California.
authors: B A
authors: BA
authors: Runyon
mesh_terms: D000368:Aged; D001202:Ascitic Fluid / Q000378:metabolism*; D001424:Bacterial Infections / Q000175:diagnosis*; D001663:Bilirubin / Q000378:metabolism*; D003937:Diagnosis, Differential; D005705:Gallbladder Diseases / Q000175:diagnosis; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis*; D008297:Male; D010538:Peritonitis / Q000175:diagnosis*; D012422:Rupture, Spontaneous
chemical_list: D001663:Bilirubin