Needle Biopsy of Peritoneum in Exudative Ascites

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.1Tuberculosis of the peritoneum presents an even greater problem since bacteriologic confirmation is usually not possible.2,3In 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.6The first report of needle biopsy of the peritoneum by Donohoe et al7contains 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