ISSN 2398-2950      

Peritoneal: effusion

ffelis
Contributor(s):

Yvonne McGrotty


Introduction

  • Accumulation of fluid within the peritoneal cavity.
  • Cause: fluid may be blood, chyle, bile, urine, exudate, transudate or modified transudate.
  • Signs: abdominal distension, respiratory distress related to pressure on diaphragm
  • Diagnosis: ultrasonography, radiography and abdominocentesis.
  • Treatment: treatment of underlying cause where possible.
  • Prognosis: guarded overall, may be successfully managed.
    Follow the management tree for Peritoneal Effusion Peritoneal effusion.

Pathogenesis

Etiology

  • Fluid type reflects underlying pathophysiology:
    • Neoplasia (hepatic, splenic, intestinal, lymphoma)
    • Trauma Abdomen: trauma (bite wound, RTA (HBC - hit by car), ruptured spleen).
    • Cardiac disease    →   right sided heart failure.
    • Pericardial disease Pericardial disease. Resulting in right-sided CHF and subsequent ascites.
    • Foreign body- resulting in peritonitis Peritonitis.
    • Bladder rupture Bladder: trauma rupture resulting in uroabdomen.

Pathophysiology

  • Accumulation of fluid within the peritoneal cavity by a variety of mechanisms.

Hemorrhage

  • Trauma, ruptured spleen or neoplasia bleeding into abdominal cavity.
  • PCV of effusion is similar to that of blood and has similar white cell number.
  • Usually doesn't clot due to rapid loss of fibrin (in contrast to inadvertent aspiration from blood vessel).

Chyle

  • True chylous effusion is usually caused by abnormal or obstructed lymph channels:
    • Lymphangiectasia.
    • Inflammation or obstruction of flow, eg neoplasia, right-sided heart failure.
    • Lymphoproliferative disease affecting mesenteric lymph nodes.

Exudate

  • Introduction of bacteria into peritoneal space, eg bite wound, foreign body, intestinal perforation, rupture of pyometra.
  • Migration of WBCs    →   abdominal cavity, or inflammatory conditions affecting peritoneum, eg neoplasia.

Transudate

  • Due to imbalance of absorption and filtration of fluid across peritoneal lining.
  • May be due to:
    • Increase of capillary hydrostatic pressure.
    • Portal hypertension.
    • Hypoalbuminaemia.

Modified transudate

  • Long-standing transudates which have increased protein and cells secondary to peritoneal inflammation.
  • May be due to:
    • Hepatic disease.
    • Right-sided congestive heart failure.
    • Abdominal neoplasia.

Timecourse

  • Acute to chronic.

Diagnosis

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Levin G M, Bonczynski J J, Ludwig L L et al (2004) Lactate as a Diagnostic Test for Septic Peritoneal Effusions in Dogs and Cats. J Am Anim Hosp Assoc 40 (5), 364-371 PubMed.
  • Bonczynski J J, Ludwig L L, Barton L J et al (2003) Comparison of Peritoneal Fluid and Peripheral Blood pH, Bicarbonate, Glucose, and Lactate Concentration as a Diagnostic Tool for Septic Peritonitis in Dogs and Cats. Vet Surg 32 (2), 161-6 PubMed.
  • Tyler R D & Cowell R L (1989) Evaluation of pleural and peritoneal effusions. Vet Clin North Am Small Anim Pract 19 (4), 743-768 PubMed.

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!

 
 
 
 

To show you are not a Bot please can you enter the number showing adjacent to this field

 Security code