Bovis ISSN 2398-2993

Abdominocentesis

Contributor(s): Mo Kemp, Vetstream Ltd , Gayle Hallowell

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Introduction

  • Abdominocentesis is used:
    • To obtain peritoneal fluid for analysis.
    • To aid in the differential diagnosis of abdominal pathology.
    • Can assist the decision to perform surgery or treat medically in the animal with abdominal pain.
    • Can assist in the diagnosis of ascites.

Uses

Advantages

  • Simple and low cost procedure.
  • Relatively safe.
  • Provides useful information is assessing the cause of ascites and in assessing abdominal pain.
  • Grossly abnormal samples can be interpreted cow-side, (eg urine identified, serosanguinous fluid or turbid inflammatory fluid that clots).
  • Repeated sampling over time to evaluate changes in the fluid parameters is very useful, especially where the diagnosis is unclear initially, or where monitoring of ongoing treatment is required.

Disadvantages

  • In adult cattle the rumen takes up large part of ventral abdomen therefore avoiding penetration is important.
  • The omentum of the cow is extremely efficient at trapping fluid and many attempts at paracentesis do not yield a sample.
  •  Abnormal peritoneal fluid may be confined to a small area of the peritoneal cavity, which may be missed during abdominocentesis.
    • This can be avoided by choosing a cranial or caudal site, depending on the likely underlying pathology.
    • Or by using ultrasound, if available, to locate the best site for abdominocentesis.
  • Failure to collect sample does not mean that ascites Ascites: overview is not present.
    • Reports suggest needs to be more than 500ml free abdominal fluid to successfully gain fluid by abdominocentesis.
  • Bowel puncture (enterocentesis) - relatively common but rarely causes clinical problems.
  • Damage to serosal surface of intestine → adhesions.
  • Contamination of sample with blood or gut contents.
  • Greater risk of enterocentesis/serosal trauma in cases with distended abdomen, particularly if a distended viscus has been palpated on rectal examination.
  • In adult cows care needs to be taken to avoid penetration of the mammary veins, especially in dairy cattle
  • Risk to operator from kick - ensure adequate restraint Restraint techniques.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Wittek T, Grosche T, Locher L, Alkaassem A & Fürll M (2010) Biochemical constituents of peritoneal fluid in cows. Vet rec 166, 15-19 PubMed.
  • Kopcha M & Schultze A E (1991) Peritoneal fluid. Part 2. Abdominocentesis in cattle and interpretation of nonneoplastic samples. Compendium on continuing education for the practicing veterinarian 13, 279-28.
  • Wilson A D, Hirsch V M & Osborne A D (1985) Abdominocentesis in cattle: technique and criteria for diagnosis of peritonitis. Can vet j  26, 74-80 PubMed.


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