TY  - CHAP
M1  - Book, Section
TI  - Paracentesis (Abdominal)
A1  - Gomella, Tricia Lacy
A1  - Cunningham, M. Douglas
A1  - Eyal, Fabien G.
A1  - Tuttle, Deborah J.
PY  - 2013
T2  - Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 7e
AB  - To  obtain  peritoneal  fluid  for  diagnostic  tests  to  determine  the  cause  of  ascites.  Ascites  is  an  excessive  amount  of  fluid  in  the  peritoneal  cavity  and  in  the  neonate  it  is  usually  urinary,  biliary,  or  chylous.  Other  causes  can  occur  but  are  less  common.  Urinary  ascites.  Due  to  perforation  of  the  ureter,  intrarenal  collecting  system,  or  bladder  (intraperitoneal)  often  caused  by  a  distal  obstruction.  The  most  common  cause  is  posterior  urethral  valves.  Other  causes:  ureterocele,  ureteral  stenosis,  urethral  stenosis/atresia,  neurogenic  bladder,  urogenital  sinus,  congenital  nephrotic  syndrome,  bladder  neck  obstruction,  and  renal  vein  thrombosis.Biliary  ascites.  Due  to  perforation  of  bile  duct  (more  common),  injury  to  the  bile  ducts,  or  a  choledochal  cyst.Chylous  ascites.  Slightly  more  common  in  males  and  usually  idiopathic.  Other  causes  include  a  congenital  lymphatic  abnormality  (more  common),  or  disruption  of  the  lymphatic  ducts  from  trauma  or  surgery.Hepatocellular  ascites.  Can  be  caused  by  neonatal  hepatitis,  viral  hepatitis,  congenital  hepatic  fibrosis,  Budd-Chiari  syndrome,  or  hepatic/portal  vein  thrombosis.Pancreatic  ascites.  Usually  caused  by  trauma  or  pseudocysts.Gastrointestinal  causes  of  ascites.  Any  perforation  of  the  gastrointestinal  tract  (gastric,  others),  necrotizing  enterocolitis  (NEC)  with  perforation/peritonitis,  meconium  peritonitis,  perforation  of  the  Meckel  diverticulum,  atresia,  malrotation,  volvulus,  gastroschisis,  omphalocele,  postabdominal  surgery,  or  intussucsception.  Peritonitis  in  neonates  is  most  commonly  associated  with  gastrointestinal  tract  perforations.Infections.  Most  common  is  congenital  (CMV,  toxoplasmosis,  syphilis,  and  others)  but  can  also  be  from  fungal,  viral  (parvovirus,  enterovirus),  or  bacterial  infections.Inborn  errors  of  metabolism.  Glycogen  storage  disorders,  lysosomal  storage  disorders,  and  galactosemia  can  all  cause  ascites.  Examples  include  infantile  free  sialic  acid  storage  disorder  (ISSD),  Salla  disease,  GM1  gangliosidosis  and  Gaucher  disease,  a1-antitrypsin  deficiency.Cardiac  abnormalities.  Congestive  heart  failure  and  right-sided  heart  obstruction  can  cause  ascites.Chromosomal  causes.  Turner  syndrome  and  trisomy  21.Iatrogenic.  Can  occur  from  fluid  from  central  venous  catheters  or  intraperitoneal  extravasation  of  total  parenteral  nutrition  (TPN)  from  a  umbilical  vein  catheterization-related  vessel  perforation.  See  Chapter  44.Hemoperitoneum  (bloody  ascites).  Uncommon  but  can  be  nontraumatic  (hepatoblastoma)  or  secondary  to  birth  trauma  (hepatic,  splenic,  or  adrenal)  or  secondary  to  a  ruptured  internal  organ.  Splenic  trauma  can  be  associated  with  consumptive  coagulopathy.As  a  therapeutic  procedure,  such  as  removal  of  peritoneal  fluid  from  massive  ascites  or  air  from  a  pneumoperitoneum  to  aid  in  ventilation  in  a  patient  with  cardiorespiratory  compromise.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/16
UR  - accesspediatrics.mhmedical.com/content.aspx?aid=1107527508
ER  -