An experience with diagnostic paracentesis in 100 cases of acute abdomen.

ABSTRACT

Prognosis of acute surgical conditions of abdomen of both traumatic and non-traumatic origin depends on accurate diagnosis and early surgical intervention. However, the diagnosis in acute abdomen is quite difficult. The problem becomes more complex when 24 hours services of radiology and laboratories are not available. Abdominal tap gives a valuable clue to diagnosis. A 10 ml syringe fitted with a 20 gauge intravenous needle was used for the purpose. Both the flanks and the four quadrants of the abdomen were selected for site of the tap according to the suspected pathology. Results were indicated as positive when abnormal fluid (clear, turbid, purulent, bloody, serosanguinous, bile stained and urine, etc) were aspirated. Accurate diagnosis were made in 84.3% in blunt abdominal trauma and 76.47% in non-traumatic acute abdomen. High incidence of accurate results were obtained in gastroduodenal perforations (92%), ruptured ectopic gestation (100%) and burst amoebic liver abscess (100%). The procedure is very simple which could be done at bed side without much disturbance to the severely ill patients. It is safe and free from any complications even if the bowel is also punctured during the tap.