Needle Biopsy of Peritoneum in Exudative Ascites

Abstract

IT IS often difficult to establish a diagnosis in patients presenting with exudative ascites. Cytopathology may establish the diagnosis in the presence of malignancy, but most institutions are not able to approach the 86% accuracy achievable under ideal conditions.¹ Tuberculosis of the peritoneum presents an even greater problem since bacteriologic confirmation is usually not possible.^2,3 In the past, the etiology of most cases of exudative ascites, particularly those of tuberculous etiology, has been established by surgical exploration or laparoscopy.^4,5 Needle biopsy of the peritoneum is an easy, safe procedure.⁶ The first report of needle biopsy of the peritoneum by Donohoe et al⁷ contains an excellent discussion of the rationale for the employment of this new technique. The authors used a modified Vim-Silverman needle and achieved the correct histologic diagnosis in seven of 14 patients studied. Despite the fact that there were no complications and the